SCA2 (ATXN2) Genetic Testing (Repeat Expansion)
Use
Spinocerebellar ataxias (SCAs) and episodic ataxias are the most common types of autosomal dominant cerebellar ataxias (ADCAs). SCAs are numbered based upon their time of identification. SCA3 is the most common type of SCA worldwide, followed by SCA2, SCA1, and SCA6. Some of the complicated forms have not been given a SCA number, like Dentatorubral Pallidoluysian Atrophy (DRPLA). Anticipation can be observed in the autosomal dominant ataxias in which CAG trinucleotide repeats occur. Anticipation results from expansion in the number of CAG repeats with transmission of the gene to subsequent generations. Most ADCAs have an overlap in clinical presentation, which makes it hard to differentiate. The most frequent clinical symptoms in all ADCAs are progressive adult-onset gait ataxia (often with hand dysmetria), and dysarthria associated with cerebellar atrophy. The episodic ataxias are characterized by periods of unsteady gait and often associated with nystagmus or dysarthria. Myokymia, vertigo, or hearing loss may occur in some of the subtypes. Permanent ataxia and even cerebellar atrophy may result late in the disease course. Repeat expansions in the ATXN2 gene may also be associated with Amyotrophic Lateral Sclerosis, or ALS. ALS is a neurodegenerative disease characterized by progressive motor neuron loss, muscle weakness and wasting, muscle spasticity, and loss of motor control.1 Several studies have shown that an intermediate allele length of 30-33 CAG repeats may correlate with an increased risk factor of ALS.2 ATXN2 reports include additional interpretation to cover ALS in addition to Spinocerebellar Ataxia type 2.
Special Instructions
This test employs repeat-primed PCR and fragment length analysis to determine the number of nucleotide repeats. Specimen collection can include whole blood, oral swab, or extracted DNA, with specific handling and volume requirements for each type. Collecting whole blood requires a lavender-top (EDTA) tube, and oral swabs should follow the kit instructions.
Limitations
The test may produce false positive or negative results due to insufficient information about rare genetic variants, allele dropout, or other factors such as blood transfusions, bone marrow transplantations, somatic or tissue-specific mosaicism, or mislabeled samples. The test has a maximum reportable size for repeat expansion testing up to 150 repeats for the ATXN2 gene. Repeat sizes greater than this are reported as exceeding the maximum reportable size.
Methodology
PCR-based (Repeat-primed PCR and fragment length analysis)
Biomarkers
Result Turnaround Time
14-28 days
Related Documents
For more information, please review the documents below
Specimen
Whole Blood
Volume
4 mL
Minimum Volume
2 mL
Container
lavender-top (EDTA) tube
Collection Instructions
Standard phlebotomy
Storage Instructions
Maintain specimen at room temperature or refrigerate 4°C. Do not freeze.
Causes for Rejection
Frozen or hemolyzed specimen; quantity not sufficient for analysis; improper container
Stability Requirements
| Temperature | Period |
|---|---|
| Room Temperature | 14 days |
| Refrigerated | 30 days |
| Frozen | do not freeze |
