Ataxia Panel
In addition, it also includes the maternally inherited mitochondrial genome.
Is ideal for patients with a clinical suspicion of ataxia when repeat expansion variants are excluded either as clinically incompatible or by previous testing.
If you are interested in a panel with FMR1 repeat expansion, click here
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Summary
The Blueprint Genetics Ataxia Panel (test code NE2101):
Read about our accreditations, certifications and CE-marked IVD medical devices here.
ICD Codes
Refer to the most current version of ICD-10-CM manual for a complete list of ICD-10 codes.
Sample Requirements
- Blood (min. 1ml) in an EDTA tube
- Extracted DNA, min. 2 μg in TE buffer or equivalent
- Saliva (Please see Sample Requirements for accepted saliva kits)
Label the sample tube with your patient’s name, date of birth and the date of sample collection.
We do not accept DNA samples isolated from formalin-fixed paraffin-embedded (FFPE) tissue. In addition, if the patient is affected with a hematological malignancy, DNA extracted from a non-hematological source (e.g. skin fibroblasts) is strongly recommended.
Please note that, in rare cases, mitochondrial genome (mtDNA) variants may not be detectable in blood or saliva in which case DNA extracted from post-mitotic tissue such as skeletal muscle may be a better option.
Read more about our sample requirements here.
The hereditary ataxias including cerebellar ataxias, episodic ataxias and spinocerebellar ataxias
are a group of genetic disorders characterized by slowly progressive incoordination of gait and often associated with poor coordination of hands, speech, and eye movements. Frequently, atrophy of the cerebellum occurs. The episodic ataxias are characterized by periods of unsteady gait often associated with nystagmus or dysarthria. Myokymia, vertigo, or hearing loss may occur in some of the subtypes. The prevalence of the autosomal dominant cerebellar ataxias (ADCAs) is estimated to be approximately 1-5:100,000. Most ADCAs are spinocerebellar ataxias (SCA) or episodic ataxias. Autosomal recessive types of hereditary ataxia account for approximately 3:100,000 with Friedreich ataxia, ataxia-telangiectasia, and ataxia oculomotor apraxia being most common. Most of the spastic ataxias are recessively inherited.
Genes in the Ataxia Panel and their clinical significance
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Gene | Associated phenotypes | Inheritance | ClinVar | HGMD |
---|---|---|---|---|
AARS2 | Leukoencephalopathy, progressive, with ovarian failure, Combined oxidative phosphorylation deficiency 8 | AR | 19 | 31 |
ABCA2 | Intellectual disability and seizures | AR | 4 | |
ABCB7 | Anemia, sideroblastic, and spinocerebellar ataxia | XL | 8 | 9 |
ABCD1* | Adrenoleukodystrophy | XL | 95 | 663 |
ABHD12 | Polyneuropathy, hearing loss, ataxia, retinitis pigmentosa, and cataract | AR | 16 | 20 |
ACO2 | Optic atrophy, Infantile cerebellar-retinal degeneration | AD/AR | 16 | 15 |
ADCK3 | Coenzyme Q10 deficiency, Progressive cerebellar ataxia and atrophy, Spinocerebellar ataxia | AR | 45 | 43 |
ADPRHL2 | Neurodegeneration, childhood-onset, with brain atrophy | AR | 1 | |
AFG3L2* | Spastic ataxia, Spinocerebellar ataxia | AD/AR | 22 | 40 |
AGTPBP1 | Neuropathy | AR | 3 | 1 |
AHI1 | Joubert syndrome | AR | 62 | 93 |
ALDH5A1 | Succinic semialdehyde dehydrogenase deficiency | AR | 16 | 70 |
ANO10 | Spinocerebellar ataxia | AR | 19 | 18 |
APTX | Ataxia, early-onset, with oculomotor apraxia and hypoalbuminemia | AR | 14 | 46 |
ARL13B | Joubert syndrome | AR | 11 | 10 |
ARL6 | Bardet-Biedl syndrome, Retinitis pigmentosa | AR | 14 | 21 |
ATCAY | Ataxia, cerebellar, Cayman | AR | 1 | 3 |
ATM | Breast cancer, Ataxia-Telangiectasia | AD/AR | 1047 | 1109 |
ATP13A2 | Parkinson disease (Kufor-Rakeb syndrome) | AR | 21 | 40 |
ATP1A3 | Alternating hemiplegia of childhood, Dystonia 12 | AD | 79 | 112 |
ATP2B3 | Spinocerebellar ataxia, X-linked 1 | XL | 6 | 7 |
ATP7B | Wilson disease | AR | 219 | 897 |
ATP8A2 | Dysequilibrium syndrome | AR | 9 | 11 |
AUH | 3-methylglutaconic aciduria | AR | 12 | 11 |
BBS1 | Bardet-Biedl syndrome | AR | 66 | 103 |
BBS10 | Bardet-Biedl syndrome | AR | 90 | 107 |
BBS12 | Bardet-Biedl syndrome | AR | 36 | 58 |
BBS2 | Bardet-Biedl syndrome, Retinitis pigmentosa | AR | 58 | 91 |
BBS4 | Bardet-Biedl syndrome | AR | 25 | 53 |
BBS5 | Bardet-Biedl syndrome | AR | 18 | 31 |
BBS7 | Bardet-Biedl syndrome | AR | 19 | 43 |
BBS9 | Bardet-Biedl syndrome | AR | 27 | 52 |
BEAN1# | Spinocerebellar ataxia | AD | 1 | 2 |
C10ORF2 | Perrault syndrome, Mitochondrial DNA depletion syndrome, Progressive external ophthalmoplegia with mitochondrial DNA deletions, autosomal dominant, 3 | AD/AR | 37 | 80 |
C12ORF4 | Developmental delay and seizures with or without movement abnormalities (DEDSM) | AR | 1 | 5 |
C5ORF42 | Orofaciodigital syndrome VI, Joubert syndrome 17 | AR | 97 | 103 |
CA8 | Cerebellar ataxia, mental retardation, and dysequilibrium syndrome | AR | 4 | 4 |
CACNA1A | Migraine, familial hemiplegic, Episodic ataxia, Spinocerebellar ataxia 6, Epileptic encephalopathy, early infantile, 42 | AD | 135 | 230 |
CACNA1G | Spinocerebellar ataxia 42 | 8 | 11 | |
CACNA2D2 | Early infantile epileptic encephalopathy, High voltage gated calcium channelopathy-related, autosomal recessive | AR | 5 | 5 |
CACNB4 | Episodic ataxia, Epilepsy, idiopathic generalized, susceptibility to, 9 | AD | 2 | 7 |
CAMTA1 | Cerebellar ataxia, nonprogressive, with mental retardation | AD | 38 | 8 |
CAPN1 | Spastic paraplegia 76, autosomal recessive | AR | 6 | 16 |
CASK | Intellectual developmental disorder and microcephaly with pontine and cerebellar hypoplasia, FG syndrome, Intellectual developmental disorder | XL | 87 | 112 |
CC2D2A# | COACH syndrome, Joubert syndrome, Meckel syndrome | AR | 76 | 91 |
CCDC88C | Spinocerebellar ataxia | AD | 6 | 10 |
CEP290* | Bardet-Biedl syndrome, Leber congenital amaurosis, Joubert syndrome, Senior-Loken syndrome, Meckel syndrome | AR | 130 | 289 |
CEP41 | Joubert syndrome | AR/Digenic | 7 | 11 |
CHCHD10 | Myopathy, isolated mitochondrial, Frontotemporal dementia and/or amyotrophic lateral sclerosis 2, Spinal muscular atrophy, Jokela type | AD | 4 | 26 |
CLCN2 | Leukoencephalopathy with ataxia, Epilepsy | AD/AR | 30 | 36 |
CLN5 | Neuronal ceroid lipofuscinosis, type 5 | AR | 62 | 47 |
CLN6 | Neuronal ceroid lipofuscinosis, type 6 | AR | 41 | 83 |
CLN8 | Neuronal ceroid lipofuscinosis, type 8 | AR | 45 | 44 |
CLPB | 3-methylglutaconic aciduria with cataracts, neurologic involvement, and neutropenia (MEGCANN) | AD/AR | 26 | 25 |
CLPP | Deafness | AR | 4 | 13 |
COA7 | Spinocerebellar ataxia, Charcot-Marie-Tooth disease | AR | 2 | 7 |
COASY | Neurodegeneration with brain iron accumulation 6 | AR | 3 | 3 |
COQ2 | Coenzyme Q10 deficiency | AR | 16 | 31 |
COQ4 | Coenzyme Q10 deficiency 7 | AR | 14 | 13 |
COX20 | Mitochondrial complex IV deficiency | AR | 4 | 1 |
CP* | Aceruloplasminemia, Hypoceruloplasminemia | AR | 62 | 57 |
CSTB | Epilepsy, progressive myoclonic | AR | 19 | 15 |
CTBP1 | 1 | 1 | ||
CTDP1 | Congenital cataracts, facial dysmorphism, and neuropathy | AR | 1 | 1 |
CTSA | Galactosialidosis | AR | 17 | 38 |
CWF19L1 | Spinocerebellar ataxia | AR | 9 | 4 |
CYP27A1 | Cerebrotendinous xanthomatosis | AR | 69 | 110 |
CYP2U1 | Spastic paraplegia 56, autosomal recessive | AR | 14 | 19 |
CYP7B1 | Bile acid synthesis defect, Spastic paraplegia 5A, autosomal recessive | AR | 18 | 60 |
DHPS# | AR | |||
DNAJC19 | 3-methylglutaconic aciduria | AR | 3 | 6 |
DNAJC5 | Kufs disease,, Ceroid lipofuscinosis, neuronal 4, Parry | AD | 2 | 2 |
DNMT1 | Neuropathy, hereditary sensory, Cerebellar ataxia, deafness, and narcolepsy | AD | 9 | 20 |
DOCK3 | Ataxia | AR | 3 | 5 |
EBF3 | Hypotonia, ataxia, and delayed development syndrome (HADDS) | AD | 32 | 26 |
EEF2 | Spinocerebellar ataxia | AD | 1 | 2 |
ELOVL4 | Stargardt disease, Icthyosis, spastic quadriplegia, and mental retardation, Spinocerebellar ataxia | AD/AR | 13 | 14 |
ELOVL5 | Spinocerebellar ataxia | AD | 2 | 5 |
FA2H | Spastic paraplegia | AR | 18 | 51 |
FBXL4 | Mitochondrial DNA depletion syndrome | AR | 55 | 47 |
FDXR | Auditory neuropathy and optic atrophy | AR | 5 | 19 |
FGF14 | Spinocerebellar ataxia | AD | 9 | 10 |
FLVCR1 | Ataxia, posterior column, with retinitis pigmentosa | AR | 9 | 15 |
FMR1 | Premature ovarian failure, Fragile X syndrome, Fragile X tremor/ataxia syndrome | XL | 13 | 76 |
FXN* | Friedreich ataxia | AR | 13 | 63 |
GBA2 | Cerebellar ataxia with spasticity | AR | 11 | 22 |
GFAP | Alexander disease | AD | 114 | 131 |
GOSR2* | Epilepsy, progessive myoclonic | AR | 6 | 4 |
GRID2 | Spinocerebellar ataxia | AR | 11 | 20 |
GRM1 | Spinocerebellar ataxia | AD/AR | 5 | 17 |
GSS | Glutathione synthetase deficiency | AR | 8 | 38 |
HARS2 | Perrault syndrome | AR | 7 | 3 |
HEXB | Sandhoff disease | AR | 55 | 120 |
HIBCH | 3-hydroxyisobutryl-CoA hydrolase deficiency | AR | 18 | 16 |
INPP5E | Joubert syndrome, Mental retardation, truncal obesity, retinal dystrophy, and micropenis (MORM syndrome) | AR | 25 | 50 |
IRF2BPL | Neurodevelopmental disorder with hypotonia, seizures, and absent language | AD | 9 | 2 |
ITM2B | Dementia, familial Danish, Retinal dystrophy with inner retinal dysfunction and ganglion cell abnormalities, Cerebral amyloid angiopathy | AD | 3 | 6 |
ITPR1 | Spinocerebellar ataxia | AD | 35 | 89 |
KCNA1 | Episodic ataxia/myokymia syndrome | AD | 24 | 45 |
KCNC3 | Spinocerebellar ataxia | AD | 7 | 11 |
KCND3 | Brugada syndrome, Spinocerebellar ataxia 19, Spinocerebellar ataxia 22 | AD | 7 | 29 |
KCNJ10 | Seizures, sensorineural deafness, ataxia, mental retardation, and electrolyte imbalance (SESAME syndrome), Pendred syndrome, Enlarged vestibular aqueduct | AR/Digenic | 13 | 29 |
KIF1C* | Spastic ataxia | AR | 7 | 17 |
KIF5A | Spastic paraplegia | AD | 18 | 62 |
KIF7 | Acrocallosal syndrome, Hydrolethalus syndrome, Al-Gazali-Bakalinova syndrome, Joubert syndrome | AR/Digenic | 24 | 44 |
LAMA1 | Poretti-Boltshauser syndrome | AR | 32 | 40 |
LARS2 | Perrault syndrome, Hydrops, lactic acidosis, and sideroblastic anemia (HLASA) | AR | 14 | 14 |
LMNB1 | Leukodystrophy, demyelinating, adult-onset, autosomal dominant | AD | 2 | 35 |
LRPPRC | Leigh syndrome, French-Canadian type | AR | 55 | 17 |
LRSAM1 | Charcot-Marie-Tooth disease | AD/AR | 15 | 14 |
MARS2 | Combined oxidative phosphorylation deficiency | AR | 8 | 5 |
MECR | Dystonia, childhood-onset, with optic atrophy and basal ganglia abnormalities (DYTOABG) | AR | 7 | 6 |
MGME1 | Mitochondrial DNA depletion syndrome 11 | AR | 3 | 7 |
MKKS | Bardet-Biedl syndrome, McKusick-Kaufman syndrome | AR | 21 | 59 |
MKS1 | Bardet-Biedl syndrome, Meckel syndrome | AR | 50 | 52 |
MME | Spinocerebellar ataxia 43, Charcot-Marie-Tooth disease, axonal, type 2T | AD/AR | 14 | 21 |
MRE11A | Ataxia-telangiectasia-like disorder-1 | AR | 57 | 56 |
MSTO1#* | Myopathy, mitochondrial, and ataxia | AR | 7 | 8 |
MT-ATP6 | Neuropathy, ataxia, and retinitis pigmentosa, Leber hereditary optic neuropathy, Ataxia and polyneuropathy, adult-onset, Cardiomyopathy, infantile hypertrophic, Leigh syndrome, Striatonigral degeneration, infantile, mitochondrial | Mitochondrial | 19 | |
MT-ATP8 | Cardiomyopathy, apical hypertrophic, and neuropathy, Cardiomyopathy, infantile hypertrophic | Mitochondrial | 4 | |
MT-CO1 | Myoglobinuria, recurrent, Leber hereditary optic neuropathy, Sideroblastic anemia, Cytochrome C oxidase deficiency, Deafness, mitochondrial | Mitochondrial | 17 | |
MT-CO2 | Cytochrome c oxidase deficiency | Mitochondrial | 8 | |
MT-CO3 | Cytochrome c oxidase deficiency, Leber hereditary optic neuropathy | Mitochondrial | 9 | |
MT-CYB | Mitochondrial | 69 | ||
MT-ND1 | Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes, Leber hereditary optic neuropathy, Leber optic atrophy and dystonia | Mitochondrial | 21 | |
MT-ND2 | Leber hereditary optic neuropathy, Mitochondrial complex I deficiency | Mitochondrial | 6 | |
MT-ND3 | Leber optic atrophy and dystonia, Mitochondrial complex I deficiency | Mitochondrial | 7 | |
MT-ND4 | Leber hereditary optic neuropathy, Leber optic atrophy and dystonia, Mitochondrial complex I deficiency | Mitochondrial | 11 | |
MT-ND4L | Leber hereditary optic neuropathy | Mitochondrial | 2 | |
MT-ND5 | Myoclonic epilepsy with ragged red fibers, Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes, Leber hereditary optic neuropathy, Mitochondrial complex I deficiency | Mitochondrial | 19 | |
MT-ND6 | Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes, Oncocytoma, Leber hereditary optic neuropathy, Leber optic atrophy and dystonia, Mitochondrial complex I deficiency | Mitochondrial | 16 | |
MT-RNR1 | Deafness, mitochondrial | Mitochondrial | 3 | |
MT-RNR2 | Chloramphenicol toxicity/resistance | Mitochondrial | 2 | |
MT-TA | Mitochondrial | 4 | ||
MT-TC | Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes | Mitochondrial | 3 | |
MT-TD | Mitochondrial | 1 | ||
MT-TE | Diabetes-deafness syndrome, Mitochondrial myopathy, infantile, transient, Mitochondrial myopathy with diabetes | Mitochondrial | 5 | |
MT-TF | Myoclonic epilepsy with ragged red fibers, Nephropathy, tubulointerstitial, Encephalopathy, mitochondrial, Epilepsy, mitochondrial, Myopathy, mitochondrial, Mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes | Mitochondrial | 7 | |
MT-TG | Mitochondrial | 3 | ||
MT-TH | Mitochondrial | 4 | ||
MT-TI | Mitochondrial | 7 | ||
MT-TK | Myoclonic epilepsy with ragged red fibers, Leigh syndrome | Mitochondrial | 5 | |
MT-TL1 | Cytochrome c oxidase deficiency, Myoclonic epilepsy with ragged red fibers, Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes, Diabetes-deafness syndrome, Cyclic vomiting syndrome, SIDS, susceptibility to | Mitochondrial | 14 | |
MT-TL2 | Mitochondrial multisystemic disorder, Progressive external ophthalmoplegia, Mitochondrial Myopathy, Mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes | Mitochondrial | 5 | |
MT-TM | Leigh syndrome, Mitochondrial multisystemic disorder | Mitochondrial | 1 | |
MT-TN | Progressive external ophthalmoplegia, Mitochondrial multisystemic disorder | Mitochondrial | 3 | |
MT-TP | Mitochondrial | 2 | ||
MT-TQ | Mitochondrial multisystemic disorder | Mitochondrial | 2 | |
MT-TR | Encephalopathy, mitochondrial | Mitochondrial | 2 | |
MT-TS1 | Myoclonic epilepsy with ragged red fibers, Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes | Mitochondrial | 10 | |
MT-TS2 | Mitochondrial multisystemic disorder | Mitochondrial | 2 | |
MT-TT | Mitochondrial | 5 | ||
MT-TV | Hypertrophic cardiomyopathy (HCM), Leigh syndrome, Mitochondrial multisystemic disorder, Mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes | Mitochondrial | 3 | |
MT-TW | Leigh syndrome, Myopathy, mitochondrial | Mitochondrial | 8 | |
MT-TY | Mitochondrial multisystemic disorder | Mitochondrial | 4 | |
MTFMT | Combined oxidative phosphorylation deficiency 15 | AR | 15 | 16 |
MTPAP | Spastic ataxia | AR | 1 | 2 |
MTTP | Abetalipoproteinemia | AR | 12 | 69 |
NDUFAF6 | Mitochondrial complex I deficiency, Leigh syndrome | AR | 18 | 10 |
NDUFS2 | Mitochondrial complex I deficiency | AR | 5 | 24 |
NDUFS4 | Mitochondrial complex I deficiency, Leigh syndrome | AR | 11 | 17 |
NDUFS7 | Mitochondrial complex I deficiency, Leigh syndrome | AR | 5 | 7 |
NDUFS8 | Mitochondrial complex I deficiency, Leigh syndrome | AR | 13 | 12 |
NDUFV1 | Mitochondrial complex I deficiency | AR | 19 | 35 |
NKX2-1 | Thyroid cancer, nonmedullary, Choreoathetosis, hypothyroidism, and neonatal respiratory distress, Chorea, hereditary benign | AD | 27 | 137 |
NKX6-2 | Spastic ataxia 8, autosomal recessive, with hypomyelinating leukodystrophy | AR | 4 | 8 |
NOL3 | Myoclonus, familial cortical | AD | 1 | 3 |
NPC1 | Niemann-Pick disease | AR | 164 | 472 |
NPC2 | Niemann-pick disease | AR | 21 | 27 |
NPHP1 | Nephronophthisis, Joubert syndrome, Senior-Loken syndrome | AR | 19 | 76 |
NUBPL | Mitochondrial complex I deficiency | AR | 9 | 10 |
OFD1 | Simpson-Golabi-Behmel syndrome, Retinitis pigmentosa, Orofaciodigital syndrome, Joubert syndrome | XL | 153 | 160 |
OPA1 | Optic atrophy, Optic atrophy 1, Optic atrophy with or without deafness, Ophthalmoplegia, myopathy, ataxia, and neuropathy, Behr synrome, Mitochondrial DNA depletion syndrome 14 | AD/AR | 96 | 390 |
OPHN1 | Mental retardation, with cerebellar hypoplasia and distinctive facial appearance | XL | 28 | 42 |
PANK2 | Hypoprebetalipoproteinemia, acanthocytosis, retinitis pigmentosa, and pallidal degeneration, Neurodegeneration with brain iron accumulation | AR | 37 | 181 |
PAX6 | Aniridia, cerebellar ataxia, and intellectual disability (Gillespie syndrome), Keratitis, Coloboma, ocular, Cataract with late-onset corneal dystrophy, Morning glory disc anomaly, Foveal hypoplasia, Aniridia, Optic nerve hypoplasia, Peters anomaly | AD | 144 | 550 |
PDYN | Spinocerebellar ataxia | AD | 4 | 11 |
PEX10 | Adrenoleukodystrophy, neonatal, Zellweger syndrome, Peroxisome biogenesis disorder, Ataxia | AR | 34 | 29 |
PEX16 | Zellweger syndrome, Peroxisome biogenesis disorder | AR | 8 | 13 |
PEX2 | Zellweger syndrome, Peroxisome biogenesis disorder | AR | 16 | 18 |
PEX3 | Zellweger syndrome, Peroxisome biogenesis disorder | AR | 4 | 10 |
PEX6 | Heimler syndrome, Peroxisome biogenesis disorder 4A, Peroxisome biogenesis disorder 4B | AR | 58 | 107 |
PEX7 | Refsum disease, Rhizomelic CDP type 1 | AR | 44 | 53 |
PHYH | Refsum disease | AR | 12 | 36 |
PMM2 | Congenital disorder of glycosylation | AR | 76 | 128 |
PNKD | Paroxysmal non-kinesigenic dyskinesia | AD | 5 | 5 |
PNKP | Epileptic encephalopathy, early infantile, Ataxia-oculomotor | AR | 34 | 23 |
PNPLA6 | Laurence-Moon syndrome, Boucher-Neuhauser syndrome, Spastic paraplegia 39 | AR | 26 | 58 |
POLG | POLG-related ataxia neuropathy spectrum disorders, Sensory ataxia, dysarthria, and ophthalmoparesis, Alpers syndrome, Progressive external ophthalmoplegia with mitochondrial DNA deletions, Mitochondrial DNA depletion syndrome | AD/AR | 89 | 290 |
PRKCG | Spinocerebellar ataxia | AD/AR | 28 | 47 |
PRRT2 | Episodic kinesigenic dyskinesia, Seizures, benign familial infantile, 2, Convulsions, familial infantile, with paroxysmal choreoathetosis | AD | 42 | 99 |
PUM1 | Ataxia, Neurodevelopmental disorder | AD | 3 | 11 |
RNF216* | Cerebellar ataxia and hypogonadotropic hypogonadism (Gordon Holmes syndrome) | AR | 10 | 14 |
RORA | AD | 6 | 15 | |
RPGRIP1L# | COACH syndrome, Joubert syndrome, Meckel syndrome, Retinal degeneration in ciliopathy, modifier | AR | 39 | 49 |
RUBCN | Spinocerebellar ataxia | AR | 4 | 4 |
SACS | Spastic ataxia, Charlevoix-Saguenay | AR | 254 | 262 |
SAMD9L | Ataxia-pancytopenia syndrome | AD | 4 | 16 |
SCYL1 | Spinocerebellar ataxia, autosomal recessive 21 | AR | 12 | 6 |
SERAC1 | 3-methylglutaconic aciduria with deafness, encephalopathy, and Leigh-like syndrome | AR | 22 | 52 |
SETX | Ataxia with oculomotor apraxia, Amyotrophic lateral sclerosis, juvenile, Spinocerebellar ataxia | AD/AR | 36 | 210 |
SH3TC2 | Mononeuropathy of the median nerve, Charcot-Marie-Tooth disease | AR | 63 | 89 |
SIL1 | Marinesco-Sjogren syndrome | AR | 14 | 49 |
SLC17A5 | Sialuria, Finnish (Salla disease), Infantile sialic acid storage disorder | AR | 52 | 54 |
SLC1A3 | Episodic ataxia | AD | 2 | 17 |
SLC20A2 | Basal ganglia calcification, idiopathic, 1 | AD | 22 | 71 |
SLC25A15* | Hyperornithinemia-hyperammonemia-homocitrullinemia syndrome | AR | 24 | 36 |
SLC25A46 | Neuropathy, hereditary motor and sensory, type VIB | AR | 14 | 17 |
SLC2A1 | Stomatin-deficient cryohydrocytosis with neurologic defects, Epilepsy, idiopathic generalized, GLUT1 deficiency syndrome | AD/AR | 106 | 275 |
SLC52A2 | Brown-Vialetto-Van Laere syndrome | AR | 27 | 25 |
SLC9A1 | Spinocerebellar ataxia, autosomal recessive 19 (Lichtenstein-Knorr syndrome) | AR | 2 | 4 |
SLC9A6 | Mental retardation, syndromic, Christianson | XL | 24 | 28 |
SNX14 | Spinocerebellar ataxia | AR | 15 | 18 |
SPG11 | Spastic paraplegia, Amyotrophic lateral sclerosis, Charcot-Marie-Tooth disease | AR | 162 | 274 |
SPG20 | Spastic paraplegia (Troyer syndrome) | AR | 9 | 7 |
SPG7 | Spastic paraplegia | AD/AR | 69 | 111 |
SPTBN2 | Spinocerebellar ataxia | AD/AR | 18 | 28 |
SQSTM1 | Paget disease of bone, Frontotemporal dementia and/or amyotrophic lateral sclerosis 3, Myopathy, distal, with rimmed vacuoles, Neurodegeneration with ataxia, dystonia, and gaze palsy, childhood-onset | AD/AR | 10 | 97 |
STUB1 | Spinocerebellar ataxia | AD/AR | 13 | 28 |
STXBP1 | Epileptic encephalopathy, early infantile | AD | 140 | 190 |
SUOX | Sulfocysteinuria | AR | 8 | 29 |
SYNE1 | Spinocerebellar ataxia, autosomal recessive 8 | AD/AR | 83 | 136 |
SYT14#* | Spinocerebellar ataxia | AR | 5 | 3 |
TCTN1# | Joubert syndrome | AR | 6 | 6 |
TCTN2 | Joubert syndrome, Meckel syndrome | AR | 20 | 15 |
TCTN3 | Orofaciodigital syndrome (Mohr-Majewski syndrome), Joubert syndrome | AR | 9 | 12 |
TDP1 | Spinocerebellar ataxia, with axonal neuropathy | AR | 1 | 3 |
TDP2 | Spinocerebellar ataxia, autosomal recessive 23 | 2 | 6 | |
TGM6 | Spinocerebellar ataxia | AD | 8 | 24 |
TMEM138 | Joubert syndrome | AR | 6 | 8 |
TMEM216 | Joubert syndrome, Meckel syndrome | AR | 17 | 8 |
TMEM231 | Joubert syndrome, Meckel syndrome | AR | 12 | 19 |
TMEM237 | Joubert syndrome | AR | 7 | 11 |
TMEM240 | Spinocerebellar ataxia | AD | 8 | 6 |
TMEM67 | Nephronophthisis, COACH syndrome, Joubert syndrome, Meckel syndrome | AR | 87 | 170 |
TPP1 | Spinocerebellar ataxia, Neuronal ceroid lipofuscinosis type 2 | AR | 75 | 112 |
TRAPPC11 | Limb-girdle muscular dystrophy | AR | 13 | 17 |
TRIM32 | Bardet-Biedl syndrome, Muscular dystrophy, limb-girdle | AR | 13 | 16 |
TTBK2 | Spinocerebellar ataxia | AD | 4 | 9 |
TTC19 | Mitochondrial complex III deficiency, nuclear type 2 | AR | 13 | 10 |
TTC8 | Bardet-Biedl syndrome, Retinitis pigmentosa | AR | 5 | 16 |
TTPA | Ataxia with isolated vitamin E deficiency | AR | 29 | 30 |
TUBB4A* | Leukodystrophy, hypomyelinating, Dystonia | AD | 39 | 42 |
UBA5* | Epileptic encephalopathy, early infantile, 44, Spinocerebellar ataxia, autosomal recessive 24 | AR | 16 | 15 |
UBTF | Neurodegeneration, childhood-onset, with brain atrophy | AD | 3 | 1 |
UCHL1 | Parkinson disease 5, autosomal dominant, Spastic paraplegia 79, autosomal recessive | AD/AR | 5 | 5 |
VAMP1 | Spastic ataxia | AD | 3 | 6 |
VLDLR | Cerebellar ataxia, mental retardation, and dysequilibrium syndrome | AR | 11 | 24 |
VPS13D | Spinocerebellar ataxia | AR | 9 | 4 |
VWA3B | Spinocerebellar ataxia, autosomal recessive 22 | 1 | 4 | |
WDPCP | Meckel-Gruber syndrome, modifier, Bardet-Biedl syndrome, Congenital heart defects, hamartomas of tongue, and polysyndactyly | AR | 6 | 8 |
WDR81 | Dysequilibrium syndrome | AR | 8 | 17 |
WFS1 | Wolfram syndrome, Wolfram-like syndrome, autosomal dominant, Deafness, autosomal dominant 6/14/38, Cataract 41 | AD/AR | 69 | 362 |
WWOX | Epileptic encephalopathy, early infantile, Spinocerebellar ataxia | AR | 43 | 45 |
XRCC1 | Spinocerebellar ataxia, autosomal recessive, 26 | 2 | 3 | |
ZFYVE26 | Spastic paraplegia 15 | AR | 63 | 39 |
ZNF423 | Nephronophthisis, Joubert syndrome | AD/AR | 10 | 7 |
The gene has suboptimal coverage (means <90% of the gene’s target nucleotides are covered at >20x with mapping quality score (MQ>20) reads), and/or the gene has exons listed under Test limitations section that are not included in the panel as they are not sufficiently covered with high quality sequence reads.
Some, or all, of the gene is duplicated in the genome. Read more.
The sensitivity to detect variants may be limited in genes marked with an asterisk (*) or number sign (#). Due to possible limitations these genes may not be available as single gene tests.
Gene refers to the HGNC approved gene symbol; Inheritance refers to inheritance patterns such as autosomal dominant (AD), autosomal recessive (AR), mitochondrial (mi), X-linked (XL), X-linked dominant (XLD) and X-linked recessive (XLR); ClinVar refers to the number of variants in the gene classified as pathogenic or likely pathogenic in this database (ClinVar); HGMD refers to the number of variants with possible disease association in the gene listed in Human Gene Mutation Database (HGMD). The list of associated, gene specific phenotypes are generated from CGD or Mitomap databases.
Non-coding variants covered by Ataxia Panel
To view complete table content, scroll horizontally.
Gene | Genomic location HG19 | HGVS | RefSeq | RS-number |
---|---|---|---|---|
ADCK3 | Chr1:227174508 | c.*72dupG | NM_020247.4 | |
ATM | Chr11:108093770 | c.-174A>G | NM_000051.3 | |
ATM | Chr11:108094508 | c.-31+595G>A | NM_000051.3 | |
ATM | Chr11:108098321 | c.-30-1G>T | NM_000051.3 | rs869312754 |
ATM | Chr11:108138753 | c.2639-384A>G | NM_000051.3 | |
ATM | Chr11:108141209 | c.2839-579_2839-576delAAGT | NM_000051.3 | |
ATM | Chr11:108151710 | c.3403-12T>A | NM_000051.3 | rs201370733 |
ATM | Chr11:108158168 | c.3994-159A>G | NM_000051.3 | rs864622543 |
ATM | Chr11:108164028 | c.4612-12A>G | NM_000051.3 | |
ATM | Chr11:108179837 | c.5763-1050A>G | NM_000051.3 | rs774925473 |
ATM | Chr11:108214779 | c.8418+681A>G | NM_000051.3 | rs748635985 |
ATP7B | Chr13:52518439 | c.3061-12T>A | NM_000053.3 | |
ATP7B | Chr13:52585551 | c.-78A>C | NM_000053.3 | |
ATP7B | Chr13:52585596 | c.-123C>A | NM_000053.3 | |
ATP7B | Chr13:52585596 | c.-128_-124delAGCCG | NM_000053.3 | |
ATP7B | Chr13:52585606 | c.-133A>C | NM_000053.3 | |
ATP7B | Chr13:52585683 | c.-210A>T | NM_000053.3 | |
ATP7B | Chr13:52585894 | NM_000053.3 | rs1484840087 | |
ATP7B | Chr13:52585897 | NM_000053.3 | ||
ATP7B | Chr13:52585915 | c.-442G>A | NM_000053.3 | |
BBS1 | Chr11:66291105 | c.951+58C>T | NM_024649.4 | |
BBS4 | Chr15:73001820 | c.77-216delA | NM_033028.4 | rs113994189 |
BBS5 | Chr2:170354110 | c.619-27T>G | NM_152384.2 | |
CACNA1A | Chr19:13317355 | c.*1500_*1504dupCTTTT | NM_001127221.1 | |
CACNA1A | Chr19:13341036 | c.5404-13G>A | NM_001127221.1 | |
CACNA1A | Chr19:13617793 | NM_001127221.1 | rs965852937 | |
CEP290 | Chr12:88462434 | c.6012-12T>A | NM_025114.3 | rs752197734 |
CEP290 | Chr12:88494960 | c.2991+1655A>G | NM_025114.3 | rs281865192 |
CEP290 | Chr12:88508350 | c.1910-11T>G | NM_025114.3 | |
CEP290 | Chr12:88534822 | c.103-18_103-13delGCTTTT | NM_025114.3 | |
CLN6 | Chr15:68506515 | c.297+113G>C | NM_017882.2 | |
FMR1 | ChrX:147031110 | c.*746T>C | NM_002024.5 | rs183130936 |
GSS | Chr20:33537864 | c.129+1663A>G | NM_000178.2 | |
GSS | Chr20:33543525 | c.-9+5G>A | NM_000178.2 | |
HEXB | Chr5:74014605 | c.1243-17A>G | NM_000521.3 | |
HEXB | Chr5:74016442 | c.1509-26G>A | NM_000521.3 | rs201580118 |
HEXB | Chr5:74016585 | c.1613+15_1613+18dupAAGT | NM_000521.3 | rs779273534 |
HEXB | Chr5:74016926 | c.1614-16_1615dupTTCATGTTATCTACAGAC | NM_000521.3 | rs756912360 |
HEXB | Chr5:74016929 | c.1614-14C>A | NM_000521.3 | rs201448394 |
KCNJ10 | Chr1:160039811 | c.-1+1G>T | NM_002241.4 | rs796052606 |
MTTP | Chr4:100512792 | c.619-5_619-2delTTTA | NM_000253.2 | rs755155385 |
MTTP | Chr4:100522736 | c.1237-28A>G | NM_000253.2 | |
NDUFAF6 | Chr8:96046914 | c.298-768T>C | NM_152416.3 | rs575462405 |
NDUFAF6 | Chr8:96048588 | c.420+784C>T | NM_152416.3 | rs749738738 |
NPC1 | Chr18:21132700 | c.1554-1009G>A | NM_000271.4 | |
NPC1 | Chr18:21137182 | c.882-28A>T | NM_000271.4 | |
NPC1 | Chr18:21137182 | c.882-28A>G | NM_000271.4 | |
NPC1 | Chr18:21137182 | c.882-28A>G/T | NM_000271.4 | |
OFD1 | ChrX:13768358 | c.935+706A>G | NM_003611.2 | rs730880283 |
OFD1 | ChrX:13773245 | c.1130-22_1130-19delAATT | NM_003611.2 | rs312262865 |
OFD1 | ChrX:13773249 | c.1130-20_1130-16delTTGGT | NM_003611.2 | |
OPA1 | Chr3:193334932 | c.449-34dupA | NM_130837.2 | |
OPA1 | Chr3:193374829 | c.2179-40G>C | NM_130837.2 | |
PANK2 | Chr20:3903981 | c.*40G>C | NM_153638.2 | |
PAX6 | Chr11:31685945 | c.*125537G>T | NM_000280.4 | rs606231388 |
PAX6 | Chr11:31812434 | c.1033-42_1033-26delATGTGTTCCTCAGTAACinsG | NM_000280.4 | |
PAX6 | Chr11:31816377 | c.524-41T>G | NM_000280.4 | |
PAX6 | Chr11:31823338 | c.142-14C>G | NM_000280.4 | rs1131692291 |
PAX6 | Chr11:31828391 | c.-52+5delG | NM_000280.4 | |
PAX6 | Chr11:31828391 | c.-52+3_-52+6delAAGTinsTG | NM_000280.4 | |
PAX6 | Chr11:31828392 | c.-52+3_-52+4delAA | NM_000280.4 | |
PAX6 | Chr11:31828395 | c.-52+1delG | NM_000280.4 | |
PAX6 | Chr11:31828396 | c.-52+1G>A | NM_000280.4 | |
PAX6 | Chr11:31828456 | c.-115_-112delACTA | NM_000280.4 | rs1011844558 |
PAX6 | Chr11:31828461 | c.-118_-117delTT | NM_000280.4 | |
PAX6 | Chr11:31828469 | c.-125dupG | NM_000280.4 | |
PAX6 | Chr11:31828474 | c.-128-2delA | NM_000280.4 | rs1131692282 |
PAX6 | Chr11:31828474 | c.-128-1G>T | NM_000280.4 | |
PAX6 | Chr11:31832372 | c.-138_-129+3delCCTCATAAAGGTG | NM_000280.4 | |
PAX6 | Chr11:31832374 | c.-129+2T>A | NM_000280.4 | |
PAX6 | Chr11:31832375 | c.-129+1G>A | NM_000280.4 | |
PEX6 | Chr6:42933858 | c.2301-15C>G | NM_000287.3 | rs267608236 |
PEX6 | Chr6:42933952 | c.2300+28G>A | NM_000287.3 | rs267608237 |
PEX7 | Chr6:137143759 | c.-45C>T | NM_000288.3 | rs267608252 |
PMM2 | Chr16:8891573 | NM_000303.2 | ||
PMM2 | Chr16:8898599 | c.179-25A>G | NM_000303.2 | rs760689221 |
PMM2 | Chr16:8926102 | c.640-15479C>T | NM_000303.2 | rs1258107584 |
PMM2 | Chr16:8941558 | c.640-23A>G | NM_000303.2 | |
PNKP | Chr19:50364799 | c.1387-33_1386+49delCCTCCTCCCCTGACCCC | NM_007254.3 | rs752902474 |
PRRT2 | Chr16:29825620 | c.*345G>A | NM_001256443.1 | |
SERAC1 | Chr6:158576548 | c.92-165C>T | NM_032861.3 | |
SERAC1 | Chr6:158576622 | c.92-239G>C | NM_032861.3 | |
SH3TC2 | Chr5:148406329 | c.2873-14T>A | NM_024577.3 | |
SH3TC2 | Chr5:148422415 | c.386-15G>A | NM_024577.3 | |
SIL1 | Chr5:138283180 | c.1030-18G>A | NM_022464.4 | rs769052639 |
SLC20A2 | Chr8:42328683 | c.289+937G>A | NM_006749.4 | |
SLC2A1 | Chr1:43395462 | c.680-11G>A | NM_006516.2 | |
SLC2A1 | Chr1:43424429 | c.-107G>A | NM_006516.2 | |
SLC52A2 | Chr8:145582843 | c.-110-1G>A | NM_024531.4 | |
STUB1 | Chr16:732729 | c.*240T>C | NM_005861.2 | |
SYNE1 | Chr6:152640163 | c.16237-13C>G | NM_182961.3 | |
SYNE1 | Chr6:152643033 | c.15918-12A>G | NM_182961.3 | rs606231134 |
TMEM231 | Chr16:75575364 | c.824-11T>C | NM_001077416.2 | |
TPP1 | Chr11:6637752 | c.887-18A>G | NM_000391.3 | |
TTC19 | Chr17:15903121 | c.-42G>T | NM_017775.3 | rs769078093 |
WFS1 | Chr4:6271704 | c.-43G>T | NM_006005.3 |
Test Strengths
The strengths of this test include:
- CAP accredited laboratory
- CLIA-certified personnel performing clinical testing in a CLIA-certified laboratory
- Powerful sequencing technologies, advanced target enrichment methods and precision bioinformatics pipelines ensure superior analytical performance
- Careful construction of clinically effective and scientifically justified gene panels
- Some of the panels include the whole mitochondrial genome (please see the Panel Content section)
- Our Nucleus online portal providing transparent and easy access to quality and performance data at the patient level
- ~2,000 non-coding disease causing variants in our clinical grade NGS assay for panels (please see ‘Non-coding disease causing variants covered by this panel’ in the Panel Content section)
- Our rigorous variant classification scheme
- Our systematic clinical interpretation workflow using proprietary software enabling accurate and traceable processing of NGS data
- Our comprehensive clinical statements
Test Limitations
Repeat expansion variants are not detected by this panel. The following exons are not included in the panel as they are not sufficiently covered with high quality sequence reads: *BEAN1* (NM_001178020:5), *CC2D2A* (NM_020785:7), *DHPS* (NM_001206974:1), *RPGRIP1L* (NM_015272:23), *SYT14* (NM_001146261:3), *TCTN1* (NM_001173976:2;NM_024549:6). Genes with suboptimal coverage in our assay are marked with number sign (#) and genes with partial, or whole gene, segmental duplications in the human genome are marked with an asterisk (*) if they overlap with the UCSC pseudogene regions. Gene is considered to have suboptimal coverage when >90% of the gene’s target nucleotides are not covered at >20x with mapping quality score (MQ>20) reads. The technology may have limited sensitivity to detect variants in genes marked with these symbols (please see the Panel content table above).
This test does not detect the following:
- Complex inversions
- Gene conversions
- Balanced translocations
- Some of the panels include the whole mitochondrial genome but not all (please see the Panel Content section)
- Repeat expansion disorders unless specifically mentioned
- Non-coding variants deeper than ±20 base pairs from exon-intron boundary unless otherwise indicated (please see above Panel Content / non-coding variants covered by the panel).
This test may not reliably detect the following:
- Low level mosaicism in nuclear genes (variant with a minor allele fraction of 14.6% is detected with 90% probability)
- Stretches of mononucleotide repeats
- Low level heteroplasmy in mtDNA (>90% are detected at 5% level)
- Indels larger than 50bp
- Single exon deletions or duplications
- Variants within pseudogene regions/duplicated segments
- Some disease causing variants present in mtDNA are not detectable from blood, thus post-mitotic tissue such as skeletal muscle may be required for establishing molecular diagnosis.
The sensitivity of this test may be reduced if DNA is extracted by a laboratory other than Blueprint Genetics.
For additional information, please refer to the Test performance section.
The genes on the panel have been carefully selected based on scientific literature, mutation databases and our experience.
Our panels are sectioned from our high-quality, clinical grade NGS assay. Please see our sequencing and detection performance table for details regarding our ability to detect different types of alterations (Table).
Assays have been validated for various sample types including EDTA-blood, isolated DNA (excluding from formalin fixed paraffin embedded tissue), saliva and dry blood spots (filter cards). These sample types were selected in order to maximize the likelihood for high-quality DNA yield. The diagnostic yield varies depending on the assay used, referring healthcare professional, hospital and country. Plus analysis increases the likelihood of finding a genetic diagnosis for your patient, as large deletions and duplications cannot be detected using sequence analysis alone. Blueprint Genetics’ Plus Analysis is a combination of both sequencing and deletion/duplication (copy number variant (CNV)) analysis.
The performance metrics listed below are from an initial validation performed at our main laboratory in Finland. The performance metrics of our laboratory in Marlborough, MA, are equivalent.
Performance of Blueprint Genetics high-quality, clinical grade NGS sequencing assay for panels.
Sensitivity % (TP/(TP+FN) | Specificity % | |
---|---|---|
Single nucleotide variants | 99.89% (99,153/99,266) | >99.9999% |
Insertions, deletions and indels by sequence analysis | ||
1-10 bps | 99.2% (7,745/7,806) | >99.9999% |
11-50 bps | 99.13% (2,524/2,546) | >99.9999% |
Copy number variants (exon level dels/dups) | ||
1 exon level deletion (heterozygous) | 100% (20/20) | NA |
1 exon level deletion (homozygous) | 100% (5/5) | NA |
1 exon level deletion (het or homo) | 100% (25/25) | NA |
2-7 exon level deletion (het or homo) | 100% (44/44) | NA |
1-9 exon level duplication (het or homo) | 75% (6/8) | NA |
Simulated CNV detection | ||
5 exons level deletion/duplication | 98.7% | 100.00% |
Microdeletion/-duplication sdrs (large CNVs, n=37)) | ||
Size range (0.1-47 Mb) | 100% (25/25) | |
The performance presented above reached by Blueprint Genetics high-quality, clinical grade NGS sequencing assay with the following coverage metrics | ||
Mean sequencing depth | 143X | |
Nucleotides with >20x sequencing coverage (%) | 99.86% |
Performance of Blueprint Genetics Mitochondrial Sequencing Assay.
Sensitivity % | Specificity % | |
---|---|---|
ANALYTIC VALIDATION (NA samples; n=4) | ||
Single nucleotide variants | ||
Heteroplasmic (45-100%) | 100.0% (50/50) | 100.0% |
Heteroplasmic (35-45%) | 100.0% (87/87) | 100.0% |
Heteroplasmic (25-35%) | 100.0% (73/73) | 100.0% |
Heteroplasmic (15-25%) | 100.0% (77/77) | 100.0% |
Heteroplasmic (10-15%) | 100.0% (74/74) | 100.0% |
Heteroplasmic (5-10%) | 100.0% (3/3) | 100.0% |
Heteroplasmic (<5%) | 50.0% (2/4) | 100.0% |
CLINICAL VALIDATION (n=76 samples) | ||
All types | ||
Single nucleotide variants n=2026 SNVs | ||
Heteroplasmic (45-100%) | 100.0% (1940/1940) | 100.0% |
Heteroplasmic (35-45%) | 100.0% (4/4) | 100.0% |
Heteroplasmic (25-35%) | 100.0% (3/3) | 100.0% |
Heteroplasmic (15-25%) | 100.0% (3/3) | 100.0% |
Heteroplasmic (10-15%) | 100.0% (9/9) | 100.0% |
Heteroplasmic (5-10%) | 92.3% (12/13) | 99.98% |
Heteroplasmic (<5%) | 88.9% (48/54) | 99.93% |
Insertions and deletions by sequence analysis n=40 indels | ||
Heteroplasmic (45-100%) 1-10bp | 100.0% (32/32) | 100.0% |
Heteroplasmic (5-45%) 1-10bp | 100.0% (3/3) | 100.0% |
Heteroplasmic (<5%) 1-10bp | 100.0% (5/5) | 99,997% |
SIMULATION DATA /(mitomap mutations) | ||
Insertions, and deletions 1-24 bps by sequence analysis; n=17 | ||
Homoplasmic (100%) 1-24bp | 100.0% (17/17) | 99.98% |
Heteroplasmic (50%) | 100.0% (17/17) | 99.99% |
Heteroplasmic (25%) | 100.0% (17/17) | 100.0% |
Heteroplasmic (20%) | 100.0% (17/17) | 100.0% |
Heteroplasmic (15%) | 100.0% (17/17) | 100.0% |
Heteroplasmic (10%) | 94.1% (16/17) | 100.0% |
Heteroplasmic (5%) | 94.1% (16/17) | 100.0% |
Copy number variants (separate artifical mutations; n=1500) | ||
Homoplasmic (100%) 500 bp, 1kb, 5 kb | 100.0% | 100.0% |
Heteroplasmic (50%) 500 bp, 1kb, 5 kb | 100.0% | 100.0% |
Heteroplasmic (30%) 500 bp, 1kb, 5 kb | 100.0% | 100.0% |
Heteroplasmic (20%) 500 bp, 1kb, 5 kb | 99.7% | 100.0% |
Heteroplasmic (10%) 500 bp, 1kb, 5 kb | 99.0% | 100.0% |
The performance presented above reached by following coverage metrics at assay level (n=66) | ||
Mean of medians | Median of medians | |
Mean sequencing depth MQ0 (clinical) | 18224X | 17366X |
Nucleotides with >1000x MQ0 sequencing coverage (%) (clinical) | 100% | |
rho zero cell line (=no mtDNA), mean sequencing depth | 12X |
The target region for each gene includes coding exons and ±20 base pairs from the exon-intron boundary. In addition, the panel includes non-coding and regulatory variants if listed above (Non-coding variants covered by the panel). Some regions of the gene(s) may be removed from the panel if specifically mentioned in the ‘Test limitations” section above. If the test includes the mitochondrial genome the target region gene list contains the mitochondrial genes. The sequencing data generated in our laboratory is analyzed with our proprietary data analysis and annotation pipeline, integrating state-of-the art algorithms and industry-standard software solutions. Incorporation of rigorous quality control steps throughout the workflow of the pipeline ensures the consistency, validity and accuracy of results. Our pipeline is streamlined to maximize sensitivity without sacrificing specificity. We have incorporated a number of reference population databases and mutation databases including, but not limited, to 1000 Genomes Project, gnomAD, ClinVar and HGMD into our clinical interpretation software to make the process effective and efficient. For missense variants, in silico variant prediction tools such as SIFT, PolyPhen,MutationTaster are used to assist with variant classification. Through our online ordering and statement reporting system, Nucleus, ordering providers have access to the details of the analysis, including patient specific sequencing metrics, a gene level coverage plot and a list of regions with suboptimal coverage (<20X for nuclear genes and <1000X for mtDNA) if applicable. This reflects our mission to build fully transparent diagnostics where ordering providers can easily visualize the crucial details of the analysis process.
We provide customers with the most comprehensive clinical report available on the market. Clinical interpretation requires a fundamental understanding of clinical genetics and genetic principles. At Blueprint Genetics, our PhD molecular geneticists, medical geneticists, and clinical consultants prepare the clinical statement together by evaluating the identified variants in the context of the phenotypic information provided in the requisition form. Our goal is to provide clinically meaningful statements that are understandable for all medical professionals regardless of whether they have formal training in genetics.
Variant classification is the cornerstone of clinical interpretation and resulting patient management decisions. Our classifications follow the ACMG guideline 2015.
The final step in the analysis is orthogonal confirmation. Sequence and copy number variants classified as pathogenic, likely pathogenic, and variants of uncertain significance (VUS) are confirmed using bi-directional Sanger sequencing or by orthogonal methods such as qPCR/ddPCR when they do not meet our stringent NGS quality metrics for a true positive call.
Our clinical statement includes tables for sequencing and copy number variants that include basic variant information (genomic coordinates, HGVS nomenclature, zygosity, allele frequencies, in silico predictions, OMIM phenotypes, and classification of the variant). In addition, the statement includes detailed descriptions of the variant, gene, and phenotype(s) including the role of the specific gene in human disease, the mutation profile, information about the gene’s variation in population cohorts, and detailed information about related phenotypes. We also provide links to the references, abstracts, and variant databases used to help ordering providers further evaluate the reported findings if desired. The conclusion summarizes all of the existing information and provides our rationale for the classification of the variant.
Identification of pathogenic or likely pathogenic variants in dominant disorders or their combinations in different alleles in recessive disorders are considered molecular confirmation of the clinical diagnosis. In these cases, family member testing can be used for risk stratification. We do not recommend using variants of uncertain significance (VUS) for family member risk stratification or patient management. Genetic counseling is recommended.
Our interpretation team analyzes millions of variants from thousands of individuals with rare diseases. Our internal database and our understanding of variants and related phenotypes increases with every case analyzed. Our laboratory is therefore well-positioned to re-classify previously reported variants as new information becomes available. If a variant previously reported by Blueprint Genetics is re-classified, our laboratory will issue a follow-up statement to the original ordering healthcare provider at no additional cost, according to our latest follow-up reporting policy.
Other
- Ataxia Study Group
- Ataxia UK
- Episodic Ataxia
- GeneReviews - Episodic Ataxia Type 1
- GeneReviews - Episodic Ataxia Type 2
- GeneReviews - Hereditary Ataxia
- NORD - Autosomal Dominant Hereditary Ataxia
- NORD - Spinocerebellar Ataxia with Axonal Neuropathy
- National Ataxia Foundation
- Spinocerebellar Ataxia Australia
- euro-ataxia