Consensus recommendations for next-generation sequencing-based genetic testing in Rare Neurological diseases
Year: 2026
Type: article
Abstract: We recently established an external quality assessment (EQA) scheme for next-generation sequencing (NGS) diagnostics in rare neurological disorders (RND) in collaboration with the EMQN. The first assessment rounds revealed limitations and variability in the quality and completeness of genetic testing reports. To improve and harmonize reporting in NGS-based diagnostics for RND, we identified 28 topics requiring recommendations based on EQA findings. These topics were grouped into four areas: clinical information, interpretation, methodology, and reporting. A team of 31 experts with relevant expertise was formed. Using an adapted Delphi approach, two rounds of surveys were conducted to prioritize the topics. Subsequently, area-specific expert groups met to formulate recommendations, followed by a final approval round using the five-finger consensus method involving all experts. In both Delphi rounds, all topics were rated as either very important (n = 12) or important (n = 16), and all were advanced for recommendation development. Consensus recommendations were achieved for 27 of the 28 topics. These include guidance on gene panel composition and updating, addressing disease-specific limitations of NGS (e.g., repeat expansion disorders), defining minimal quality parameters, and promoting sharing of variant interpretations. Each recommendation is supported by real-world examples. Due to differences in national healthcare frameworks and policies, consensus could not be reached regarding which patients should or should not undergo NGS testing. The dissemination of these recommendations is expected to improve the quality of genetic testing and reporting in RND diagnostics, promoting harmonization across laboratories and enabling easier comparison and interpretation of genetic testing reports.
Authors: Aleš Maver, Katja Lohmann, Lena-Marie Urbanczyk, Astri Arnesen, Ivo Barić, Peter Bauer, Kailash P. Bhatia, Sylvia Boesch, Fran Borovečki, Norbert Brüggemann, Zih-Hua Fang, Heinz Gabriel, Tobias B. Haack, Henry Houlden, Milena Janković, Erik-Jan Kamsteeg, Michelangelo Mancuso, Deborah Mascalzoni, Maria Judit Molnar, Alexander Münchau, Kornelia Neveling, Ivana Novaković, Borut Peterlin, Ludger Schols, Nika Schuermans, Katie Shiels, Marc Sturm, Rachel Taylor, Marina A. J. Tijssen, Lisenka E. L. M. Vissers, Victoria Williams, Holm Graessner, on behalf of the European Reference Network for Rare Neurological Disorders (ERN-RND)
Institutions: Ljubljana University Medical Centre, University of Lübeck, Universitätsklinikum Tübingen, University of Tübingen, University Hospital Centre Zagreb, Centogene (Germany), National Hospital for Neurology and Neurosurgery, UCL Queen Square Institute of Neurology, University College London, Innsbruck Medical University, Universität Innsbruck, University of Zagreb, German Center for Neurodegenerative Diseases, University of Belgrade, Radboud University Medical Center, University of Pisa, Uppsala University, Semmelweis University, Hertie Institute for Clinical Brain Research, Ghent University Hospital, University Medical Center Groningen
Language: English
Topic: Genomics and Rare Diseases
Subfield: Genetics
Domain: Life Sciences
Open Access status: hybrid
Estimated APC paid: $2,790
Funder: European Academy of Neurology
OpenAlex ID: W7171552591