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Genetic analysis of neurodegenerative diseases
Maurizio Grassano, Alice B. Schindler, Bryan J. Traynor, Sonja W. Scholz
Maurizio Grassano, Alice B. Schindler, Bryan J. Traynor, Sonja W. Scholz
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Review Series

Genetic analysis of neurodegenerative diseases

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Abstract

Recent advances in genomic technologies have greatly enhanced our understanding of neurodegeneration. Techniques like whole-genome sequencing, long-read sequencing, and large-scale population studies have expanded the range of identified genetic risk factors, uncovering new disease mechanisms and biological pathways that could serve as therapeutic targets. However, translating these genetic insights into clinical practice remains difficult because of challenges in interpreting variants and the limited functional validation of new discoveries. This Review highlights the key genomic technologies advancing diagnosis and research in neurodegeneration. We focus on improvements in variant classification, detection of structural variants and repeat expansions, and combining transcriptomic, proteomic, and functional data to better determine variant pathogenicity. The ongoing integration of genomics, molecular neurobiology, and data science offers great potential for more accurate, biologically informed diagnosis and treatment of neurodegenerative disorders.

Authors

Maurizio Grassano, Alice B. Schindler, Bryan J. Traynor, Sonja W. Scholz

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Figure 3

From genome-wide association to functional and translational insights.

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From genome-wide association to functional and translational insights.
(...
(A) Genome-wide association studies (GWAS) identify common genetic variants associated with phenotypes. Significant associations, visualized as peaks in a Manhattan plot, highlight genomic loci linked to disease susceptibility but often encompass multiple correlated variants within linkage disequilibrium (LD) blocks. (B) Fine mapping integrates LD structure and effect sizes to calculate the posterior probability that each variant is causal. Conditional analysis iteratively accounts for the most important variants within a locus to identify independent association signals. (C) Colocalization analysis tests whether GWAS and molecular quantitative trait locus (QTL) signals share a common causal variant. Expression QTL (eQTL) mapping associates genetic variants with gene expression levels across tissues or cell types, helping prioritize effector genes and relevant biological contexts. (D) Aggregating signals across genes or pathways enables the identification of biological processes disproportionately affected by disease-associated variants. Gene set enrichment, tissue-specific expression profiling, and network-based methods reveal convergent mechanisms. (E) Transcriptome-wide association studies (TWAS) integrate GWAS summary statistics with reference transcriptomic data to infer associations between genetically predicted gene expression and disease. Integration with drug–gene interaction databases facilitates drug repurposing by identifying compounds that counteract disease-associated expression profiles or target implicated pathways. (F) High-throughput reporter-based assays, such as massively parallel reporter assays (MPRAs), test the regulatory activity of thousands of variants simultaneously, while deep mutational scanning (DMS) assesses the functional impact of coding variants on protein stability or activity. (G) Cellular and organismal models provide experimental validation of causal mechanisms. Patient-derived cells, patient-derived organoids, and genetically engineered animal models enable functional interrogation of candidate variants and pathways in disease-relevant systems. (H) Insights from GWAS and post-GWAS analyses inform therapeutic development and precision medicine. Polygenic risk scores integrate the cumulative effects of multiple variants to stratify disease risk and predict progression, while genetic insights guide drug discovery and repurposing efforts targeting causal genes or pathways.

Copyright © 2026 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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