A Multicenter Study of Glucocerebrosidase Mutations in Dementia With Lewy Bodies Glucocerebrosidase Mutations in DLB

Nalls MA, Duran R, Lopez G, et al. — Mon, 15 Apr 2013 00:00:00 GMT

Importance

While mutations in glucocerebrosidase (GBA1) are associated with an increased risk for Parkinson disease (PD), it is important to establish whether such mutations are also a common risk factor for other Lewy body disorders.

Objective

To establish whether GBA1 mutations are a risk factor for dementia with Lewy bodies (DLB).

Design

We compared genotype data on patients and controls from 11 centers. Data concerning demographics, age at onset, disease duration, and clinical and pathological features were collected when available. We conducted pooled analyses using logistic regression to investigate GBA1 mutation carrier status as predicting DLB or PD with dementia status, using common control subjects as a reference group. Random-effects meta-analyses were conducted to account for additional heterogeneity.

Setting

Eleven centers from sites around the world performing genotyping.

Participants

Seven hundred twenty-one cases met diagnostic criteria for DLB and 151 had PD with dementia. We compared these cases with 1962 controls from the same centers matched for age, sex, and ethnicity.

Main Outcome Measures

Frequency of GBA1 mutations in cases and controls.

Results

We found a significant association between GBA1 mutation carrier status and DLB, with an odds ratio of 8.28 (95% CI, 4.78-14.88). The odds ratio for PD with dementia was 6.48 (95% CI, 2.53-15.37). The mean age at diagnosis of DLB was earlier in GBA1 mutation carriers than in noncarriers (63.5 vs 68.9 years; P < .001), with higher disease severity scores.

Conclusions and Relevance

Mutations in GBA1 are a significant risk factor for DLB. GBA1 mutations likely play an even larger role in the genetic etiology of DLB than in PD, providing insight into the role of glucocerebrosidase in Lewy body disease.

AMA Publishing Group: Lewy Body Disease Topic Collection

A Multicenter Study of Glucocerebrosidase Mutations in Dementia With Lewy Bodies Glucocerebrosidase Mutations in DLB