title: Impact of presymptomatic genetic testing for familial amyotrophic lateral sclerosis.
abstract: OBJECTIVE
  The Pre-familial Amyotrophic Lateral Sclerosis (Pre-fALS) study is a longitudinal study of individuals potentially at risk for developing familial amyotrophic lateral sclerosis. Our goals were to (1) explore participants' decisions of whether to learn results of presymptomatic testing or not; (2) understand the psychosocial impact of these decisions; and (3) assess preferences for receiving results by telephone or in person.
  
  
  METHODS
  The sample for this substudy comprised 20 participants drawn randomly from autosomal dominant mutant superoxide dismutase 1 families in the Pre-fALS study. Twenty participants completed a semistructured phone interview; prominent themes were identified and rated.
  
  
  RESULTS
  Fourteen participants chose to learn results; six had mutant superoxide dismutase 1 and eight had wild-type superoxide dismutase 1. Of the six who initially elected nondisclosure, three were reconsidering their decision. Regardless of the results and method of counseling, participants had adapted well, at least in the short term.
  
  
  CONCLUSIONS
  We recommend that (1) those considering presymptomatic genetic testing should undergo professional counseling to help decide whether to learn results; (2) discussion should include the option of telephone genetic counseling for those without easy access to in-person counseling; and (3) those who initially decline to learn results should be offered the opportunity to learn their mutation status as their decision evolves.
authors.affiliation: Department of Pediatrics, Dartmouth Medical School, Lebanon, New Hampshire, USA.
authors.forename: Joanna H
authors.initials: JH
authors.lastname: Fanos
authors.forename: Susan
authors.initials: S
authors.lastname: Gronka
authors.forename: Joanne
authors.initials: J
authors.lastname: Wuu
authors.forename: Christine
authors.initials: C
authors.lastname: Stanislaw
authors.forename: Peter M
authors.initials: PM
authors.lastname: Andersen
authors.forename: Michael
authors.initials: M
authors.lastname: Benatar
mesh_terms: D000690:Amyotrophic Lateral Sclerosis / Q000235:genetics* / Q000523:psychology*; D005260:Female; D005817:Genetic Counseling; D005820:Genetic Testing / Q000523:psychology*; D005838:Genotype; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D013482:Superoxide Dismutase / Q000235:genetics; D000072105:Superoxide Dismutase-1
chemical_list: C000606290:SOD1 protein, human; D013482:Superoxide Dismutase; D000072105:Superoxide Dismutase-1