Open research questions in Genetic Neurodegenerative Diseases
519 gap statements mined from Genetic Neurodegenerative Diseases papers in our 7.9M-paper local library, which holds 2,127 papers on the topic — drawn mostly from each paper's own stated research gap, future-work, challenge and limitation notes, and its abstract. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one.
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What the literature leaves open
This distinction becomes particularly relevant in settings where labeled data are limited, such as rare diseases, or where multimodal integration is required.
Physiology-Driven Inference Using Large Language Models Enables Probabilistic Assessment of Huntington’s Disease from Smartphone Eye-Movement Data · 2026 · DOIThis finding suggests our patient may have been diagnosed in an early phase of SCAR10 that has not yet been documented in the literature, raising the possibility that oculomotor dysfunction may serve as an early marker of cerebellar degeneration in SCAR10.
Downbeat nystagmus without ataxia as an early manifestation of spinocerebellar ataxia, autosomal recessive type 10 (SCAR10): a case report · 2026 · DOIWhile the association with age at disease onset did not remain significant after correction for multiple testing, it may warrant further investigation as a potential modifier of ALS onset.
Characterising the motif composition and allele length distribution of ZFHX3 GGC repeat expansions in amyotrophic lateral sclerosis · 2026 · DOIAnother limitation of this study is the lack of systematic biochemical evaluation for acquired and potentially treatable causes of ataxia, including gluten ataxia and vitamin deficiencies, as well as other relevant laboratory investigations such as AFP, albumin, and cholesterol levels, limiting our ability to assess their diagnostic contribution.
We collected similar feedback in this cohort compared with that in Germany and the UK regarding people’s needs for better care: improving the information delivered about ataxias, better treatment, feeling more in control with more advice on how to cope better, better access to therapies, and access to effective home care and local care if people can no longer attend the SAC.
Ataxia patient care pathway and associated healthcare costs in Italy: a cross-sectional survey · 2026 · DOIFinally, we examined only the length of the CGG repeat expansions and were unable to analyze the internal repeat structures or the methylation status, which should be investigated in greater detail in future studies. Only one patient underwent long-term ophthalmologic follow-ups, resulting in limited information on the longitudinal ophthalmologic evaluations.
Genotype–phenotype correlations in neuronal intranuclear inclusion disease-related retinopathy with CGG repeat increases in NOTCH2NLC · 2026 · DOIFuture research should focus on prospective, deeply phenotyped cohorts of FGF14-related disorders to clarify genotype–phenotype correlations, better quantify cognitive and neuropsychiatric involvement, and systematically evaluate targeted therapies, including 4-aminopyridine and deep-brain stimulation.
Phenotypic spectrum of FGF14-related late-onset ataxia: predominant tremor and cognitive decline as key features of SCA27A · 2026 · DOIIn contrast, evidence in myotonic dystrophy is more limited and largely extrapolated, particularly in DM2 where robust trial data are still lacking.
Investigations in larger cohorts, examining its temporal relationship with other neuroinflammatory protein signatures, as well as cell and animal model studies are warranted to map the mechanism of neuroimmune dysregulation associated with decreased TNFRSF8 and ultimately examine the potential to develop this axis as a drug target.
Decreased cerebrospinal fluid TNFRSF8 (sCD30) confirmed as a biomarker of Huntington’s disease progression · 2026 · DOIPsychotic symptoms in HD are a significant and understudied phenomenon with profound impact on quality of life and disease burden, often complicating disease assessment. There is evidence that they occur at an increasing rate, although it remains a rare outcome in HD, which itself is a relatively rare condition.
The diagnosis of NIID can be challenging due to non-specific symptoms. The patient's symptoms could have been attributed to other conditions, such as vestibular migraine or posterior-circulation ischemia. The lack of awareness of NIID and its symptoms can lead to delayed diagnosis.
Acute dizziness prompting diagnosis of NOTCH2NLC-related neuronal intranuclear inclusion disease: diffusion-weighted imaging and multisystem clues · 2026 · DOIHuntington's disease (HD) is characterized by degeneration of striatal medium spiny neurons (MSNs), yet the human-specific regulatory mechanisms that contribute to neuronal vulnerability remain poorly understood.
The human-specific lncRNA HD-LINC drives lipid droplet-associated neurodegeneration in Huntington's disease · 2026 · DOIIn selected patients potentially vulnerable to a reduction in LC neuroprotective effects, specific drugs that enhance NA tone might be used. In line with this, recent studies have explored potential treatments, such as the CNS NAT inhibitor atomoxetine.
Further studies into the impact of AMPylation on polyQ protein aggregation, including proteins known to be involved in the interplay between polyQ toxicity and ER stress, such as p97/VCP, will be essential for defining the direct impact of AMPylation on these proteotoxic species.
Loss of FIC-1-mediated AMPylation activates the UPRER and upregulates cytosolic HSP70 chaperones to suppress polyglutamine toxicity · 2025 · DOIIt remains an open question whether these effects would be similarly or prominently observed in the patient samples and in the animals expressing the longer repeats of DPRs, or if the presence of additional contributing factors is required. The full extent of the global consequences resulting from downregulation of this complex remains to be determined.
A fly model of SCA36 reveals combinatorial neurotoxicity of hexanucleotide and dipeptide repeats · 2025 · DOIThe primary challenge now is whether interventions targeting inflammation can effectively modify the progression and prognosis of HD, potentially delaying the onset of clinical symptoms and extending survival. Despite the notable success of immune modulators in other NDDs, anti-inflammatory or immunomodulatory therapies for HD have yielded limited results in clinical trials.
Neuroinflammatory Proteins in Huntington’s Disease: Insights into Mechanisms, Diagnosis, and Therapeutic Implications · 2024 · DOIPerturbed mitochondrial functions and disrupted protein synthesis have been reported in HD, but a detailed molecular and biochemical understanding is lacking.
Ribosome Profiling and Mass Spectrometry Reveal Widespread Mitochondrial Translation Defects in a Striatal Cell Model of Huntington Disease · 2024 · DOIDespite this, the underlying cellular mechanisms remain incompletely understood (Payne, 2022).
Frataxin deficiency drives cardiac dysfunction and transcriptional dysregulation in Friedreich ataxia iPSC model · 2026 · DOIThe potential clinical benefit of SI-targeting therapies – particularly when and in whom they should be applied – remains uncertain.
Computational modeling and preclinical evaluation support targeting somatic instability for Huntington’s disease treatment · 2026 · DOIFuture research should focus on further characterizing the relationship between genotype and phenotype, with the goal of developing personalized treatment strategies tailored to both the implicated gene and the specific variant involved.
Furthermore, the pathogenicity of numerous variants remains poorly defined in the literature, due in part to a lack of functional studies that could offer deeper insights into the pathophysiological mechanisms underlying the observed phenotypes.
DNAJB6b, a molecular chaperone involved in protein quality control, is known to efficiently suppress polyQ aggregation, but its antiaggregation mechanism remains unclear.
A Two-Bead-Per-Amino Acid Coarse-Grained MD Model with Hydrogen Bonding (2BPA-HB) to Probe DNAJB6b-Mediated Suppression of Polyglutamine Aggregation in Huntington’s Disease · 2026 · DOISpinocerebellar ataxia type 1 (SCA1) is a progressive neurodegenerative disorder caused by polyglutamine expansion in ATXN1, yet the normal physiological roles of ATXN1 and its paralog ATXN1L remain incompletely understood.
Zebrafish knockout models of atxn1a, atxn1b , and atxn1l reveal distinct and shared phenotypic and transcriptomic alterations · 2026 · DOIAlthough significant progress has been made in understanding DM1 pathogenesis, the contribution of DMPK transcript levels to disease severity, and the variability of these levels across cell types, tissues, and patients, remains poorly understood.
CRISPR/dCas9-mediated tuning of DMPK transcription reveals a quantitative relationship between toxic repeat RNA expression and MBNL1 activity in myotonic dystrophy · 2026 · DOIWhile TNFRSF8 did not demonstrate a statistically significant association with expected years to onset, a trend was observed that warrants further investigation in larger…
Decreased cerebrospinal fluid TNFRSF8 (sCD30) confirmed as a biomarker of Huntington’s disease progression · 2026 · DOI
Most-cited papers in Genetic Neurodegenerative Diseases
- Aggregation of Huntingtin in Neuronal Intranuclear Inclusions and Dystrophic Neurites in Brain · Science · 1997 · 2,372 citations
- Friedreich's Ataxia: Autosomal Recessive Disease Caused by an Intronic GAA Triplet Repeat Expansion · Science · 1996 · 2,318 citations
- 30 years of repeat expansion disorders: What have we learned and what are the remaining challenges? · The American Journal of Human Genetics · 2021 · 448 citations
- The incidence and gene frequency of ataxia-telangiectasia in the United States. · PubMed · 2020 · 399 citations
- Safety and Efficacy of Omaveloxolone in Friedreich Ataxia ( MOXIe Study) · Annals of Neurology · 2020 · 350 citations
- Huntington’s disease alters human neurodevelopment · Science · 2020 · 336 citations
- Cell Type-Specific Transcriptomics Reveals that Mutant Huntingtin Leads to Mitochondrial RNA Release and Neuronal Innate Immune Activation · Neuron · 2020 · 286 citations
- Single-nucleus RNA-seq identifies Huntington disease astrocyte states · Acta Neuropathologica Communications · 2020 · 241 citations
- Long somatic DNA-repeat expansion drives neurodegeneration in Huntington’s disease · Cell · 2025 · 230 citations
- Huntington’s disease: diagnosis and management · Practical Neurology · 2021 · 197 citations
Most recent work
- An Antibody–Oligonucleotide Conjugate for Myotonic Dystrophy Type 1 · New England Journal of Medicine · 2026
- Population-scale variability at short tandem repeat loci reveals pathogenicity signature · bioRxiv · 2026
- Oral splicing modulator branaplam in Huntington’s disease: a phase 2 randomized controlled trial · Nature Medicine · 2026
- Clinical, Genetic, and Imaging Characteristics of SCA27B : Insights from a Large Dutch Cohort · Movement Disorders · 2026
- Selective targeting of mutant huntingtin intron 1 improves rescue provided by antisense oligonucleotides in Huntington’s disease mice · Science Translational Medicine · 2026
- GGC repeat expansions within new open reading frames are translated into toxic polyglycine proteins in oculopharyngodistal myopathy · Nature Genetics · 2026
- Value of MRI Outcomes for Preventive and Early‐Stage Trials in Spinocerebellar Ataxias 1 and 3 · Annals of Clinical and Translational Neurology · 2026
- Targeting frataxin deficiency in DRG neurons and fibroblasts: omaveloxolone restores metabolic and iron balance to reduce ferroptosis · Biomedicine & Pharmacotherapy · 2026
- Lowering the HTT1a transcript as an effective therapy for Huntington’s disease in a knockin mouse model · Science Translational Medicine · 2026
- Neuroinflammatory control of metabolism in huntington’s disease: central role of P2 × 7 receptor mediated redox lipid/epigenetic crosstalk · Inflammopharmacology · 2026
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