The genetic spectrum of a cohort of patients clinically diagnosed as Parkinson’s disease in mainland China

So far, over 20 causative genes of monogenic Parkinson’s disease (PD) have been identified. Some causative genes of non-parkinsonian entities may also manifest with parkinsonism mimicking PD. This study aimed to investigate the genetic characteristics of clinically diagnosed PD with early onset age or family history. A total of 832 patients initially diagnosed with PD were enrolled, of which, 636 were classified into the early-onset group and 196 were classified into the familial late-onset group. The genetic testing included the multiplex ligation-dependent probe amplification and next generation sequencing (target sequencing or whole-exome sequencing). The dynamic variants of spinocerebellar ataxia were tested in probands with family history. In the early-onset group, 30.03% of patients (191/636) harbored pathogenic/likely pathogenic (P/LP) variants in known PD-related genes ( CHCHD2 , DJ-1 , GBA (heterozygous) , LRRK2 , PINK1 , PRKN , PLA2G6 , SNCA and VPS35 ). Variants in PRKN were the most prevalent, accounting for 15.72% of the early-onset patients, followed by GBA (10.22%), and PLA2G6 (1.89%). And 2.52% (16/636) had P/LP variants in causative genes of other diseases ( ATXN3, ATXN2, GCH1, TH, MAPT, GBA (homozygous) ). In the familial late-onset group, 8.67% of patients (17/196) carried P/LP variants in known PD-related genes ( GBA (heterozygous), HTRA2, SNCA ) and 2.04% (4/196) had P/LP variants in other genes ( ATXN2, PSEN1, DCTN1 ). Heterozygous GBA variants (7.14%) were the most common genetic cause found in familial late-onset patients. Genetic testing is of vital importance in differential diagnosis especially in early-onset and familial PD. Our findings may also provide some clues to the nomenclature of genetic movement disorders.