{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T19:29:23Z","timestamp":1790278163740,"version":"4.1.0"},"reference-count":34,"publisher":"The Korean Movement Disorder Society","issue":"2","license":[{"start":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T00:00:00Z","timestamp":1708473600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"VICO Therapeutics B.V."}],"content-domain":{"domain":["e-jmd.org"],"crossmark-restriction":true},"short-container-title":["JMD"],"published-print":{"date-parts":[[2024,4,30]]},"abstract":"<jats:p>Objective Huntington\u2019s disease (HD) is an autosomal dominant, fully penetrant, neurodegenerative disease that most commonly affects middle-aged adults. HD is caused by a CAG repeat expansion in the &lt;i&gt;HTT&lt;\/i&gt; gene, resulting in the expression of mutant huntingtin (mHTT). Our aim was to detect and quantify mHTT in tear fluid, which, to our knowledge, has never been measured before.Methods We recruited 20 manifest and 13 premanifest HD gene expansion carriers, and 20 age-matched controls. All patients underwent detailed assessments, including the Unified Huntington\u2019s Disease Rating Scale (UHDRS) total motor score (TMS) and total functional capacity (TFC) score. Tear fluid was collected using paper Schirmer\u2019s strips. The level of tear mHTT was determined using single-molecule counting SMCxPRO technology.Results The average tear mHTT levels in manifest (67,223 \u00b1 80,360 fM) and premanifest patients (55,561 \u00b1 45,931 fM) were significantly higher than those in controls (1,622 \u00b1 2,179 fM). We noted significant correlations between tear mHTT levels and CAG repeat length, \u201cestimated years to diagnosis,\u201d disease burden score and UHDRS TMS and TFC. The receiver operating curve demonstrated an almost perfect score (area under the curve [AUC] = 0.9975) when comparing controls to manifest patients. Similarly, the AUC between controls and premanifest patients was 0.9846. The optimal cutoff value for distinguishing between controls and manifest patients was 4,544 fM, whereas it was 6,596 fM for distinguishing between controls and premanifest patients.Conclusion Tear mHTT has potential for early and noninvasive detection of alterations in HD patients and could be integrated into both clinical trials and clinical diagnostics.<\/jats:p>","DOI":"10.14802\/jmd.24014","type":"journal-article","created":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T08:09:43Z","timestamp":1708502983000},"page":"181-188","update-policy":"https:\/\/doi.org\/10.14802\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["High Levels of Mutant Huntingtin Protein in Tear Fluid From Huntington\u2019s Disease Gene Expansion Carriers"],"prefix":"10.14802","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7203-0159","authenticated-orcid":true,"given":"Marlies","family":"Gijs","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nynke","family":"Jorna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2887-0238","authenticated-orcid":true,"given":"Nicole","family":"Datson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chantal","family":"Beekman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6868-0872","authenticated-orcid":true,"given":"Cira","family":"Dansokho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Weiss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5638-9292","authenticated-orcid":true,"given":"David E. J.","family":"Linden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0732-4406","authenticated-orcid":true,"given":"Mayke","family":"Oosterloo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"5803","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/0092-8674(93)90585-e"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1186\/1750-1172-5-40"},{"key":"ref3","first-page":"2307","volume-title":"Targeting huntingtin expression in patients with Huntington\u2019s 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