The marker gene set was differentially expressed in presymptomatic and symptomatic HD subjects. PCA in the training set confirmed the separation of the presymptomatic carriers of the HD mutation and HD patients from healthy control subjects (A). Using the first two principal components from the QRT-PCR training set, PCA for the 12 genes in the test set confirmed the separation of symptomatic HD patients from healthy controls (B). Early presymptomatic carriers of the HD mutation (average age, 22.5 ± 2.6 years) cluster predominantly with control samples (C), whereas late presymptomatics (average age, 39 ± 6.1 years) mostly group with symptomatic HD patients (D). PCA was performed by using the ΔCt values. For visualization in a 2D plot, the first two principal components for the training set data were chosen representing 81% of the variance in the training set. The subgroups are colored according to their clinical classification (healthy control subjects ♦, early presymptomatics ▪, late presymptomatics ▴, symptomatic HD patients •). Analysis of the individual genes revealed up-regulation of expression with progression from early presymptomatic to symptomatic stage of HD (E). All of the 12 genes were significantly up-regulated in symptomatic HD patients (▪) and late presymptomatic carriers of HD mutation (▪), compared with controls (P < 0.05). In the early presymptomatic group (▪), only annexin A1 (ANXA1), TAF7, and purinergic receptor P2Y (P2Y5) were significantly up-regulated (P < 0.05). Gene expression of the 12 selected genes in A-E was analyzed by QRT-PCR.