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Spencer BE, Xie SX, Elman LB, Quinn CC, Amado D, Baer M, Lee EB, Van Deerlin V, Dratch L, Massimo L, Irwin DJ, McMillan CT. C9orf72 repeat expansions modify risk for secondary motor and cognitive-behavioral symptoms in behavioral-variant frontotemporal degeneration and amyotrophic lateral sclerosis. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.30.24306638. [PMID: 38746326 PMCID: PMC11092697 DOI: 10.1101/2024.04.30.24306638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
In behavioral-variant frontotemporal degeneration (bvFTD) and amyotrophic lateral sclerosis (ALS), the presence of secondary motor or cognitive-behavioral symptoms, respectively, is associated with shorter survival. However, factors influencing the risk and hazard of secondary symptom development remain largely unexplored. We performed a retrospective evaluation of the entire disease course of individuals with amyotrophic lateral sclerosis (n=172) and behavioral-variant frontotemporal degeneration (n=69). Only individuals who had neuropathological confirmation of a TDP-43 proteinopathy at autopsy or had a C9orf72 repeat expansion were included for analysis. We examined the odds and hazard of secondary symptom development and assessed whether they were modified by the presence of a C9orf72 repeat expansion or initial clinical syndrome. Binary logistic regression and Cox proportional hazard analyses revealed increased odds (OR=4.25 [1.97-9.14]; p<0.001) and an increased hazard (HR= 4.77 [2.33-9.79], p<0.001) for developing secondary symptoms in C9orf72 expansion carriers compared to noncarriers. Initial clinical syndrome (bvFTD or ALS), age at symptom onset, and sex were not associated with development of secondary motor or cognitive-behavioral symptoms. These findings highlight the need for clinician vigilance to detect the onset of secondary motor symptoms and cognitive-behavioral in patients carrying a C9orf72 repeat expansion, regardless of initial clinical syndrome, and may warrant dual referrals between cognitive and neuromuscular clinics in these cases.
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Chen K, Gao T, Liu Y, Zhu K, Wang T, Zeng P. Identifying risk loci for FTD and shared genetic component with ALS: A large-scale multitrait association analysis. Neurobiol Aging 2024; 134:28-39. [PMID: 37979250 DOI: 10.1016/j.neurobiolaging.2023.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/18/2023] [Accepted: 09/25/2023] [Indexed: 11/20/2023]
Abstract
Current genome-wide association studies of frontotemporal dementia (FTD) are underpowered due to limited samples. Further, common genetic etiologies between FTD and amyotrophic lateral sclerosis (ALS) remain unknown. Using the largest summary statistics of FTD (3526 cases and 9402 controls) and ALS (27,205 cases and 110,881 controls), we found a significant genetic correlation between them (rˆg = 0.637, P = 0.032) and identified 190 FTD-related variants within 5 loci (3p22.1, 5q35.1, 9p21.2, 19p13.11, and 20q13.13). Among these, ALS and FTD had causal variants in 9p21.2 and 19p13.11. Moreover, MOBP (3p22.1), C9orf72 (9p21.2), MOB3B (9p21.2), UNC13A (19p13.11), SLC9A8 (20q13.13), SNAI1 (20q13.13), and SPATA2 (20q13.13) were discovered by both SNP- and gene-level analyses, which together discovered 15 FTD-associated genes, with 10 not detected before (IFNK, RNF114, SLC9A8, SPATA2, SNAI1, SCFD1, POLDIP2, TMEM97, G2E3, and PIGW). Functional analyses showed these genes were enriched in heart left ventricle, kidney cortex, and some brain regions. Overall, this study provides insights into genetic determinants of FTD and shared genetic etiology underlying FTD and ALS.
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Affiliation(s)
- Keying Chen
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China
| | - Tongyu Gao
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China
| | - Ying Liu
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China
| | - Kexuan Zhu
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China
| | - Ting Wang
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China
| | - Ping Zeng
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China; Center for Medical Statistics and Data Analysis, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China; Key Laboratory of Human Genetics and Environmental Medicine, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China; Key Laboratory of Environment and Health, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China; Biological Data Mining and Healthcare Transformation Innovation Engineering Research Center, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China.
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Ansari U, Chen V, Sedighi R, Syed B, Muttalib Z, Ansari K, Ansari F, Nadora D, Razick D, Lui F. Role of the UNC13 family in human diseases: A literature review. AIMS Neurosci 2023; 10:388-400. [PMID: 38188011 PMCID: PMC10767061 DOI: 10.3934/neuroscience.2023029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/28/2023] [Accepted: 12/01/2023] [Indexed: 01/09/2024] Open
Abstract
This literature review explores the pivotal roles of the Uncoordinated-13 (UNC13) protein family, encompassing UNC13A, UNC13B, UNC13C, and UNC13D, in the pathogenesis of various human diseases. These proteins, which are evolutionarily conserved and crucial for synaptic vesicle priming and exocytosis, have been implicated in a range of disorders, spanning from neurodegenerative diseases like amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) to immune-related conditions such as familial hemophagocytic lymphohistiocytosis (FHL). The involvement of UNC13A in neurotransmitter release and synaptic plasticity is linked to ALS and FTD, with genetic variations affecting disease progression. UNC13B, which is closely related to UNC13A, plays a role in autism spectrum disorders (ASD), epilepsy, and schizophrenia. UNC13C is implicated in oral squamous cell carcinoma (OSCC) and hepatocellular carcinoma (HCC), and has a neuroprotective role in Alzheimer's disease (AD). UNC13D has an essential role in immune cell function, making it a key player in FHL. This review highlights the distinct molecular functions of each UNC13 family member and their implications in disease contexts, shedding light on potential therapeutic strategies and avenues for future research. Understanding these proteins' roles offers new insights into the management and treatment of neurological and immunological disorders.
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Affiliation(s)
- Ubaid Ansari
- California Northstate University College of Medicine, USA
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4
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Willemse SW, Harley P, van Eijk RPA, Demaegd KC, Zelina P, Pasterkamp RJ, van Damme P, Ingre C, van Rheenen W, Veldink JH, Kiernan MC, Al-Chalabi A, van den Berg LH, Fratta P, van Es MA. UNC13A in amyotrophic lateral sclerosis: from genetic association to therapeutic target. J Neurol Neurosurg Psychiatry 2023; 94:649-656. [PMID: 36737245 PMCID: PMC10359588 DOI: 10.1136/jnnp-2022-330504] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 01/10/2023] [Indexed: 02/05/2023]
Abstract
Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease with limited treatment options and an incompletely understood pathophysiology. Although genomewide association studies (GWAS) have advanced our understanding of the disease, the precise manner in which risk polymorphisms contribute to disease pathogenesis remains unclear. Of relevance, GWAS have shown that a polymorphism (rs12608932) in the UNC13A gene is associated with risk for both ALS and frontotemporal dementia (FTD). Homozygosity for the C-allele at rs12608932 modifies the ALS phenotype, as these patients are more likely to have bulbar-onset disease, cognitive impairment and FTD at baseline as well as shorter survival. UNC13A is expressed in neuronal tissue and is involved in maintaining synaptic active zones, by enabling the priming and docking of synaptic vesicles. In the absence of functional TDP-43, risk variants in UNC13A lead to the inclusion of a cryptic exon in UNC13A messenger RNA, subsequently leading to nonsense mediated decay, with loss of functional protein. Depletion of UNC13A leads to impaired neurotransmission. Recent discoveries have identified UNC13A as a potential target for therapy development in ALS, with a confirmatory trial with lithium carbonate in UNC13A cases now underway and future approaches with antisense oligonucleotides currently under consideration. Considering UNC13A is a potent phenotypic modifier, it may also impact clinical trial outcomes. This present review describes the path from the initial discovery of UNC13A as a risk gene in ALS to the current therapeutic options being explored and how knowledge of its distinct phenotype needs to be taken into account in future trials.
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Affiliation(s)
- Sean W Willemse
- Department of Neurology, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - Peter Harley
- UCL Queen Square Motor Neuron Disease Centre, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Ruben P A van Eijk
- Department of Neurology, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, The Netherlands
- Biostatistics & Research Support, Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht, The Netherlands
| | - Koen C Demaegd
- Department of Neurology, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - Pavol Zelina
- Department of Translational Neuroscience, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - R Jeroen Pasterkamp
- Department of Translational Neuroscience, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - Philip van Damme
- Department of Neurology, KU Leuven Hospital, Leuven, Belgium
- Laboratory of Neurobiology, VIB KU Leuven Center for Brain and Disease Research, Leuven, Belgium
| | - Caroline Ingre
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Wouter van Rheenen
- Department of Neurology, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - Jan H Veldink
- Department of Neurology, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - Matthew C Kiernan
- Bushell Chair of Neurology, Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
- Neurology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | | | - Leonard H van den Berg
- Department of Neurology, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - Pietro Fratta
- UCL Queen Square Motor Neuron Disease Centre, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Michael A van Es
- Department of Neurology, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, The Netherlands
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Uzay B, Kavalali ET. Genetic disorders of neurotransmitter release machinery. Front Synaptic Neurosci 2023; 15:1148957. [PMID: 37066095 PMCID: PMC10102358 DOI: 10.3389/fnsyn.2023.1148957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/10/2023] [Indexed: 04/03/2023] Open
Abstract
Synaptic neurotransmitter release is an evolutionarily conserved process that mediates rapid information transfer between neurons as well as several peripheral tissues. Release of neurotransmitters are ensured by successive events such as synaptic vesicle docking and priming that prepare synaptic vesicles for rapid fusion. These events are orchestrated by interaction of different presynaptic proteins and are regulated by presynaptic calcium. Recent studies have identified various mutations in different components of neurotransmitter release machinery resulting in aberrant neurotransmitter release, which underlie a wide spectrum of psychiatric and neurological symptoms. Here, we review how these genetic alterations in different components of the core neurotransmitter release machinery affect the information transfer between neurons and how aberrant synaptic release affects nervous system function.
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Affiliation(s)
- Burak Uzay
- Vanderbilt Brain Institute, Nashville, TN, United States
- Department of Pharmacology, Vanderbilt University, Nashville, TN, United States
| | - Ege T. Kavalali
- Vanderbilt Brain Institute, Nashville, TN, United States
- Department of Pharmacology, Vanderbilt University, Nashville, TN, United States
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Mehta PR, Brown AL, Ward ME, Fratta P. The era of cryptic exons: implications for ALS-FTD. Mol Neurodegener 2023; 18:16. [PMID: 36922834 PMCID: PMC10018954 DOI: 10.1186/s13024-023-00608-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/17/2023] [Indexed: 03/18/2023] Open
Abstract
TDP-43 is an RNA-binding protein with a crucial nuclear role in splicing, and mislocalises from the nucleus to the cytoplasm in a range of neurodegenerative disorders. TDP-43 proteinopathy spans a spectrum of incurable, heterogeneous, and increasingly prevalent neurodegenerative diseases, including the amyotrophic lateral sclerosis and frontotemporal dementia disease spectrum and a significant fraction of Alzheimer's disease. There are currently no directed disease-modifying therapies for TDP-43 proteinopathies, and no way to distinguish who is affected before death. It is now clear that TDP-43 proteinopathy leads to a number of molecular changes, including the de-repression and inclusion of cryptic exons. Importantly, some of these cryptic exons lead to the loss of crucial neuronal proteins and have been shown to be key pathogenic players in disease pathogenesis (e.g., STMN2), as well as being able to modify disease progression (e.g., UNC13A). Thus, these aberrant splicing events make promising novel therapeutic targets to restore functional gene expression. Moreover, presence of these cryptic exons is highly specific to patients and areas of the brain affected by TDP-43 proteinopathy, offering the potential to develop biomarkers for early detection and stratification of patients. In summary, the discovery of cryptic exons gives hope for novel diagnostics and therapeutics on the horizon for TDP-43 proteinopathies.
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Affiliation(s)
- Puja R Mehta
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, UCL Queen Square Motor Neuron Disease Centre, London, WC1N 3BG, UK
| | - Anna-Leigh Brown
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, UCL Queen Square Motor Neuron Disease Centre, London, WC1N 3BG, UK
| | - Michael E Ward
- National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD, USA
| | - Pietro Fratta
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, UCL Queen Square Motor Neuron Disease Centre, London, WC1N 3BG, UK.
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7
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Koike Y, Pickles S, Estades Ayuso V, Jansen-West K, Qi YA, Li Z, Daughrity LM, Yue M, Zhang YJ, Cook CN, Dickson DW, Ward M, Petrucelli L, Prudencio M. TDP-43 and other hnRNPs regulate cryptic exon inclusion of a key ALS/FTD risk gene, UNC13A. PLoS Biol 2023; 21:e3002028. [PMID: 36930682 PMCID: PMC10057836 DOI: 10.1371/journal.pbio.3002028] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 03/29/2023] [Accepted: 02/08/2023] [Indexed: 03/18/2023] Open
Abstract
A major function of TAR DNA-binding protein-43 (TDP-43) is to repress the inclusion of cryptic exons during RNA splicing. One of these cryptic exons is in UNC13A, a genetic risk factor for amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD). The accumulation of cryptic UNC13A in disease is heightened by the presence of a risk haplotype located within the cryptic exon itself. Here, we revealed that TDP-43 extreme N-terminus is important to repress UNC13A cryptic exon inclusion. Further, we found hnRNP L, hnRNP A1, and hnRNP A2B1 bind UNC13A RNA and repress cryptic exon inclusion, independently of TDP-43. Finally, higher levels of hnRNP L protein associate with lower burden of UNC13A cryptic RNA in ALS/FTD brains. Our findings suggest that while TDP-43 is the main repressor of UNC13A cryptic exon inclusion, other hnRNPs contribute to its regulation and may potentially function as disease modifiers.
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Affiliation(s)
- Yuka Koike
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, United States of America
- Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, Florida, United States of America
| | - Sarah Pickles
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, United States of America
- Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, Florida, United States of America
| | - Virginia Estades Ayuso
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, United States of America
| | - Karen Jansen-West
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, United States of America
| | - Yue A. Qi
- Center for Alzheimer’s and Related Dementias, National Institute on Aging, NIH, Bethesda, Maryland, United States of America
| | - Ziyi Li
- Center for Alzheimer’s and Related Dementias, National Institute on Aging, NIH, Bethesda, Maryland, United States of America
| | - Lillian M. Daughrity
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, United States of America
| | - Mei Yue
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, United States of America
| | - Yong-Jie Zhang
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, United States of America
- Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, Florida, United States of America
| | - Casey N. Cook
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, United States of America
- Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, Florida, United States of America
| | - Dennis W. Dickson
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, United States of America
- Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, Florida, United States of America
| | - Michael Ward
- Center for Alzheimer’s and Related Dementias, National Institute on Aging, NIH, Bethesda, Maryland, United States of America
- National Institute of Neurological Disorders and Stroke, NIH, Bethesda, Maryland, United States of America
| | - Leonard Petrucelli
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, United States of America
- Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, Florida, United States of America
| | - Mercedes Prudencio
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, United States of America
- Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, Florida, United States of America
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Manini A, Casiraghi V, Brusati A, Maranzano A, Gentile F, Colombo E, Bonetti R, Peverelli S, Invernizzi S, Gentilini D, Messina S, Verde F, Poletti B, Fogh I, Morelli C, Silani V, Ratti A, Ticozzi N. Association of the risk factor UNC13A with survival and upper motor neuron involvement in amyotrophic lateral sclerosis. Front Aging Neurosci 2023; 15:1067954. [PMID: 36819716 PMCID: PMC9931189 DOI: 10.3389/fnagi.2023.1067954] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 01/03/2023] [Indexed: 02/04/2023] Open
Abstract
Background The UNC13A gene is an established susceptibility locus for amyotrophic lateral sclerosis (ALS) and a determinant of shorter survival after disease onset, with up to 33.0 months difference in life expectancy for carriers of the rs12608932 risk genotype. However, its overall effect on other clinical features and ALS phenotypic variability is controversial. Methods Genotype data of the UNC13A rs12608932 SNP (A-major allele; C-minor allele) was obtained from a cohort of 972 ALS patients. Demographic and clinical variables were collected, including cognitive and behavioral profiles, evaluated through the Edinburgh Cognitive and Behavioral ALS Screen (ECAS) - Italian version and the Frontal Behavioral Inventory (FBI); upper and lower motor neuron involvement, assessed by the Penn Upper Motor Neuron Score (PUMNS) and the Lower Motor Neuron Score (LMNS)/Medical Research Council (MRC) scores, respectively; the ALS Functional Rating Scale Revised (ALSFRS-R) score at evaluation and progression rate; age and site of onset; survival. The comparison between the three rs12608932 genotypes (AA, AC, and CC) was performed using the additive, dominant, and recessive genetic models. Results The rs12608932 minor allele frequency was 0.31 in our ALS cohort, in comparison to 0.33-0.41 reported in other Caucasian ALS populations. Carriers of at least one minor C allele (AC + CC genotypes) had a shorter median survival than patients with the wild-type AA genotype (-11.7 months, p = 0.013), even after adjusting for age and site of onset, C9orf72 mutational status and gender. Patients harboring at least one major A allele (AA + AC genotypes) and particularly those with the wild-type AA genotype showed a significantly higher PUMNS compared to CC carriers (p = 0.015 and padj = 0.037, respectively), thus indicating a more severe upper motor neuron involvement. Our analysis did not detect significant associations with all the other clinical parameters considered. Conclusion Overall, our findings confirm the role of UNC13A as a determinant of survival in ALS patients and show the association of this locus also with upper motor neuron involvement.
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Affiliation(s)
- Arianna Manini
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy,Neurology Residency Program, Università degli Studi di Milano, Milan, Italy
| | - Valeria Casiraghi
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy,Department of Medical Biotechnology and Molecular Medicine, Università degli Studi di Milano, Milan, Italy
| | - Alberto Brusati
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy,Department of Brain and Behavioral Sciences, Università degli Studi di Pavia, Pavia, Italy
| | - Alessio Maranzano
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy,Neurology Residency Program, Università degli Studi di Milano, Milan, Italy
| | - Francesco Gentile
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy,Neurology Residency Program, Università degli Studi di Milano, Milan, Italy
| | - Eleonora Colombo
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Ruggero Bonetti
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy,Neurology Residency Program, Università degli Studi di Milano, Milan, Italy
| | - Silvia Peverelli
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Sabrina Invernizzi
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Davide Gentilini
- Department of Brain and Behavioral Sciences, Università degli Studi di Pavia, Pavia, Italy,Bioinformatics and Statistical Genomics Unit, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Stefano Messina
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Federico Verde
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy,Department of Pathophysiology and Transplantation, 'Dino Ferrari' Center, Università degli Studi di Milano, Milan, Italy
| | - Barbara Poletti
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Isabella Fogh
- Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London, United Kingdom
| | - Claudia Morelli
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Vincenzo Silani
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy,Department of Pathophysiology and Transplantation, 'Dino Ferrari' Center, Università degli Studi di Milano, Milan, Italy
| | - Antonia Ratti
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy,Department of Medical Biotechnology and Molecular Medicine, Università degli Studi di Milano, Milan, Italy
| | - Nicola Ticozzi
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy,Department of Pathophysiology and Transplantation, 'Dino Ferrari' Center, Università degli Studi di Milano, Milan, Italy,*Correspondence: Nicola Ticozzi, ✉
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Strong MJ, Swash M. Finding Common Ground on the Site of Onset of Amyotrophic Lateral Sclerosis. Neurology 2022; 99:1042-1048. [PMID: 36261296 PMCID: PMC9754652 DOI: 10.1212/wnl.0000000000201387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 08/26/2022] [Indexed: 11/15/2022] Open
Abstract
The fundamental origin of amyotrophic lateral sclerosis (ALS) has remained an enigma since its earliest description as a relentlessly progressive degeneration with prominent neuromuscular manifestations that are associated with upper and lower motor neuron dysfunction. Although this remains the hallmark of ALS, a significant proportion of patients will also demonstrate one or more features of frontotemporal dysfunction, including a frontotemporal dementia (FTD). Understanding whether these 2 seemingly disparate syndromes are simply reflective of the co-occurrence of 2 distinct pathologic processes or the clinical manifestations of a common pathophysiologic derangement involving the brain more widely has gripped contemporary ALS researchers. Supporting a commonality of causation, both ALS and FTD show an alteration in the metabolism of TAR DNA-binding protein 43, marked by a shift in nucleocytoplasmic localization alongside a broad range of neuronal cytoplasmic inclusions consisting of pathologic aggregates of RNA-binding proteins. Similarly, several disease-associated or disease-modifying genetic variants that are shared between the 2 disorders suggest shared underlying mechanisms. In both, a prominent glial response has been postulated to contribute to non-cell-autonomous spread. A more contemporary hypothesis, however, suggests that syndromes of cortical and subcortical dysfunction are driven by impairments in discrete neural networks. This postulates that such networks, including networks subserving motor or cognitive function, possess unique and selective vulnerabilities to either single molecular toxicities or combinations thereof. The co-occurrence of one or more network dysfunctions in ALS and FTD is thus a reflection not of unique neuroanatomic correlates but rather of shared molecular vulnerabilities. The basis of such shared vulnerabilities becomes the fulcrum around which the next advances in our understanding of ALS and its possible therapy will develop.
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Affiliation(s)
- Michael J Strong
- From the Department of Clinical Neurological Sciences (M.J.S.), Western University, London, Canada; Department of Neurology (M.S.), Barts and the London School of Medicine QMUL, United Kingdom; and Institute of Neuroscience (M.S.), University of Lisbon, Portugal.
| | - Michael Swash
- From the Department of Clinical Neurological Sciences (M.J.S.), Western University, London, Canada; Department of Neurology (M.S.), Barts and the London School of Medicine QMUL, United Kingdom; and Institute of Neuroscience (M.S.), University of Lisbon, Portugal
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10
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Calvo A, Canosa A, Moglia C, Manera U, Grassano M, Vasta R, Palumbo F, Cugnasco P, Gallone S, Brunetti M, De Marchi F, Arena V, Pagani M, Dalgard C, Scholz SW, Chia R, Corrado L, Dalfonso S, Mazzini L, Traynor BJ, Chio A. Clinical and Metabolic Signature of UNC13A rs12608932 Variant in Amyotrophic Lateral Sclerosis. Neurol Genet 2022; 8:e200033. [PMID: 36313067 PMCID: PMC9608390 DOI: 10.1212/nxg.0000000000200033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 07/29/2022] [Indexed: 11/07/2022]
Abstract
Background and Objectives To characterize the clinical and cognitive behavioral phenotype and brain 18F-2-fluoro-2-deoxy-d-glucose-PET (18F-FDG-PET) metabolism of patients with amyotrophic lateral sclerosis (ALS) carrying the rs12608932 variant of the UNC13A gene. Methods The study population included 1,409 patients with ALS without C9orf72, SOD1, TARDBP, and FUS mutations identified through a prospective epidemiologic ALS register. Control participants included 1,012 geographically matched, age-matched, and sex-matched participants. Clinical and cognitive differences between patients carrying the C/C rs12608932 genotype and those carrying the A/A + A/C genotype were assessed. A subset of patients underwent 18F-FDG-PET. Results The C/C genotype was associated with an increased risk of ALS (odds ratio: 1.54, 95% confidence interval 1.18–2.01, p = 0.001). Patients with the C/C genotype were older, had more frequent bulbar onset, and manifested a higher rate of weight loss. In addition, they showed significantly reduced performance in the letter fluency test, fluency domain of Edinburgh Cognitive and Behavioural ALS Screen (ECAS) and story-based empathy task (reflecting social cognition). Patients with the C/C genotype had a shorter survival (median survival time, C/C 2.25 years, interquartile range [IQR] 1.33–3.92; A/A + C/C: 2.90 years, IQR 1.74–5.41; p = 0.0001). In Cox multivariable analysis, C/C genotype resulted to be an independent prognostic factor. Finally, patients with a C/C genotype had a specific pattern of hypometabolism on brain 18F-FDG-PET extending to frontal and precentral areas of the right hemisphere. Discussion C/C rs12608932 genotype of UNC13A is associated with a specific motor and cognitive/behavioral phenotype, which reflects on 18F-FDG-PET findings. Our observations highlight the importance of adding the rs12608932 variant in UNC13A to the ALS genetic panel to refine the individual prognostic prediction and reduce heterogeneity in clinical trials.
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Affiliation(s)
- Andrea Calvo
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Antonio Canosa
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Cristina Moglia
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Umberto Manera
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Maurizio Grassano
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Rosario Vasta
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Francesca Palumbo
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Paolo Cugnasco
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Salvatore Gallone
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Maura Brunetti
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Fabiola De Marchi
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Vincenzo Arena
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Marco Pagani
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Clifton Dalgard
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Sonja W Scholz
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Ruth Chia
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Lucia Corrado
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Sandra Dalfonso
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Letizia Mazzini
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Bryan J Traynor
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Adriano Chio
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
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11
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Sturmey E, Malaspina A. Blood biomarkers in ALS: challenges, applications and novel frontiers. Acta Neurol Scand 2022; 146:375-388. [PMID: 36156207 PMCID: PMC9828487 DOI: 10.1111/ane.13698] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 08/15/2022] [Accepted: 08/19/2022] [Indexed: 01/12/2023]
Abstract
Amyotrophic lateral sclerosis (ALS) is the most common motor neuron disease among adults. With diagnosis reached relatively late into the disease process, extensive motor cell loss narrows the window for therapeutic opportunities. Clinical heterogeneity in ALS and the lack of disease-specific biomarkers have so far led to large-sized clinical trials with long follow-up needed to define clinical outcomes. In advanced ALS patients, there is presently limited scope to use imaging or invasive cerebrospinal fluid (CSF) collection as a source of disease biomarkers. The development of more patient-friendly and accessible blood biomarker assays is hampered by analytical hurdles like the matrix effect of blood components. However, blood also provides the opportunity to identify disease-specific adaptive changes of the stoichiometry and conformation of target proteins and the endogenous immunological response to low-abundance brain peptides, such as neurofilaments (Nf). Among those biomarkers under investigation in ALS, the change in concentration before or after diagnosis of Nf has been shown to aid prognostication and to allow the a priori stratification of ALS patients into smaller sized and clinically more homogeneous cohorts, supporting more affordable clinical trials. Here, we discuss the technical hurdles affecting reproducible and sensitive biomarker measurement in blood. We also summarize the state of the art of non-CSF biomarkers in the study of prognosis, disease progression, and treatment response. We will then address the potential as disease-specific biomarkers of the newly discovered cryptic peptides which are formed down-stream of TDP-43 loss of function, the hallmark of ALS pathobiology.
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Affiliation(s)
- Ellie Sturmey
- Centre of Neuroscience, Surgery and Trauma, Queen Mary University of London, London, UK
| | - Andrea Malaspina
- Centre of Neuroscience, Surgery and Trauma, Queen Mary University of London, London, UK.,Queen Square Institute of Neurology, University College London, London, UK
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12
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Muacevic A, Adler JR. Homozygous UNC13A Variant in an Infant With Congenital Encephalopathy and Severe Neuromuscular Phenotype: A Case Report With Detailed Central Nervous System Neuropathologic Findings. Cureus 2022; 14:e30774. [PMID: 36447687 PMCID: PMC9701132 DOI: 10.7759/cureus.30774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2022] [Indexed: 01/25/2023] Open
Abstract
Uncoordinated 13 (UNC13A) affects movement in Caenorhabditis elegans (C. elegans). It is responsible for docking, priming, and stabilizing synaptic vesicle fusion complexes in the neuronal synapse and neuromuscular junction (NMJ). It also plays an important role in central nervous system development. We report the detailed clinical history and central nervous system neuropathologic findings in an infantile case with homozygous UNC13A loss of function variant, in order to advance the understanding of this critically important synaptic vesicle protein. This is the first detailed central nervous system neuropathologic report of this rare case of homozygous UNC13A loss.
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13
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Bauer CS, Cohen RN, Sironi F, Livesey MR, Gillingwater TH, Highley JR, Fillingham DJ, Coldicott I, Smith EF, Gibson YB, Webster CP, Grierson AJ, Bendotti C, De Vos KJ. An interaction between synapsin and C9orf72 regulates excitatory synapses and is impaired in ALS/FTD. Acta Neuropathol 2022; 144:437-464. [PMID: 35876881 PMCID: PMC9381633 DOI: 10.1007/s00401-022-02470-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 06/17/2022] [Accepted: 07/08/2022] [Indexed: 12/16/2022]
Abstract
Dysfunction and degeneration of synapses is a common feature of amyotrophic lateral sclerosis and frontotemporal dementia (ALS/FTD). A GGGGCC hexanucleotide repeat expansion in the C9ORF72 gene is the main genetic cause of ALS/FTD (C9ALS/FTD). The repeat expansion leads to reduced expression of the C9orf72 protein. How C9orf72 haploinsufficiency contributes to disease has not been resolved. Here we identify the synapsin family of synaptic vesicle proteins, the most abundant group of synaptic phosphoproteins, as novel interactors of C9orf72 at synapses and show that C9orf72 plays a cell-autonomous role in the regulation of excitatory synapses. We mapped the interaction of C9orf72 and synapsin to the N-terminal longin domain of C9orf72 and the conserved C domain of synapsin, and show interaction of the endogenous proteins in synapses. Functionally, C9orf72 deficiency reduced the number of excitatory synapses and decreased synapsin levels at remaining synapses in vitro in hippocampal neuron cultures and in vivo in the hippocampal mossy fibre system of C9orf72 knockout mice. Consistent with synaptic dysfunction, electrophysiological recordings identified impaired excitatory neurotransmission and network function in hippocampal neuron cultures with reduced C9orf72 expression, which correlated with a severe depletion of synaptic vesicles from excitatory synapses in the hippocampus of C9orf72 knockout mice. Finally, neuropathological analysis of post-mortem sections of C9ALS/FTD patient hippocampus with C9orf72 haploinsufficiency revealed a marked reduction in synapsin, indicating that disruption of the interaction between C9orf72 and synapsin may contribute to ALS/FTD pathobiology. Thus, our data show that C9orf72 plays a cell-autonomous role in the regulation of neurotransmission at excitatory synapses by interaction with synapsin and modulation of synaptic vesicle pools, and identify a novel role for C9orf72 haploinsufficiency in synaptic dysfunction in C9ALS/FTD.
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Affiliation(s)
- Claudia S Bauer
- Sheffield Institute for Translational Neuroscience (SITraN), Department of Neuroscience, University of Sheffield, 385a Glossop Road, Sheffield, S10 2HQ, UK
- Neuroscience Institute, University of Sheffield, Western Bank, Sheffield, S10 2TN, UK
| | - Rebecca N Cohen
- Sheffield Institute for Translational Neuroscience (SITraN), Department of Neuroscience, University of Sheffield, 385a Glossop Road, Sheffield, S10 2HQ, UK
- Neuroscience Institute, University of Sheffield, Western Bank, Sheffield, S10 2TN, UK
| | - Francesca Sironi
- Laboratory of Molecular Neurobiology, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milan, Italy
| | - Matthew R Livesey
- Sheffield Institute for Translational Neuroscience (SITraN), Department of Neuroscience, University of Sheffield, 385a Glossop Road, Sheffield, S10 2HQ, UK
- Neuroscience Institute, University of Sheffield, Western Bank, Sheffield, S10 2TN, UK
| | - Thomas H Gillingwater
- Edinburgh Medical School: Biomedical Sciences, University of Edinburgh, Hugh Robson Building, Edinburgh, EH8 9XD, UK
- Euan MacDonald Centre for Motor Neuron Disease Research, Chancellor's Building, University of Edinburgh, Edinburgh, EH16 4SB, UK
| | - J Robin Highley
- Sheffield Institute for Translational Neuroscience (SITraN), Department of Neuroscience, University of Sheffield, 385a Glossop Road, Sheffield, S10 2HQ, UK
- Neuroscience Institute, University of Sheffield, Western Bank, Sheffield, S10 2TN, UK
| | - Daniel J Fillingham
- Sheffield Institute for Translational Neuroscience (SITraN), Department of Neuroscience, University of Sheffield, 385a Glossop Road, Sheffield, S10 2HQ, UK
- Neuroscience Institute, University of Sheffield, Western Bank, Sheffield, S10 2TN, UK
| | - Ian Coldicott
- Sheffield Institute for Translational Neuroscience (SITraN), Department of Neuroscience, University of Sheffield, 385a Glossop Road, Sheffield, S10 2HQ, UK
- Neuroscience Institute, University of Sheffield, Western Bank, Sheffield, S10 2TN, UK
| | - Emma F Smith
- Sheffield Institute for Translational Neuroscience (SITraN), Department of Neuroscience, University of Sheffield, 385a Glossop Road, Sheffield, S10 2HQ, UK
- Neuroscience Institute, University of Sheffield, Western Bank, Sheffield, S10 2TN, UK
| | - Yolanda B Gibson
- Sheffield Institute for Translational Neuroscience (SITraN), Department of Neuroscience, University of Sheffield, 385a Glossop Road, Sheffield, S10 2HQ, UK
- Neuroscience Institute, University of Sheffield, Western Bank, Sheffield, S10 2TN, UK
| | - Christopher P Webster
- Sheffield Institute for Translational Neuroscience (SITraN), Department of Neuroscience, University of Sheffield, 385a Glossop Road, Sheffield, S10 2HQ, UK
- Neuroscience Institute, University of Sheffield, Western Bank, Sheffield, S10 2TN, UK
| | - Andrew J Grierson
- Sheffield Institute for Translational Neuroscience (SITraN), Department of Neuroscience, University of Sheffield, 385a Glossop Road, Sheffield, S10 2HQ, UK
- Neuroscience Institute, University of Sheffield, Western Bank, Sheffield, S10 2TN, UK
| | - Caterina Bendotti
- Laboratory of Molecular Neurobiology, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milan, Italy
| | - Kurt J De Vos
- Sheffield Institute for Translational Neuroscience (SITraN), Department of Neuroscience, University of Sheffield, 385a Glossop Road, Sheffield, S10 2HQ, UK.
- Neuroscience Institute, University of Sheffield, Western Bank, Sheffield, S10 2TN, UK.
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14
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Akiyama T, Koike Y, Petrucelli L, Gitler AD. Cracking the cryptic code in amyotrophic lateral sclerosis and frontotemporal dementia: Towards therapeutic targets and biomarkers. Clin Transl Med 2022; 12:e818. [PMID: 35567447 PMCID: PMC9098226 DOI: 10.1002/ctm2.818] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 03/29/2022] [Indexed: 12/19/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) are two devastating human neurodegenerative diseases. A hallmark pathological feature of both diseases is the depletion of the RNA-binding protein TDP-43 from the nucleus in the brain and spinal cord of patients. A major function of TDP-43 is to repress the inclusion of cryptic exons during RNA splicing. When it becomes depleted from the nucleus in disease, this function is lost, and recently, several key cryptic splicing targets of TDP-43 have emerged, including STMN2, UNC13A, and others. UNC13A is a major ALS/FTD risk gene, and the genetic variations that increase the risk for disease seem to do so by making the gene more susceptible to cryptic exon inclusion when TDP-43 function is impaired. Here, we discuss the prospects and challenges of harnessing these cryptic splicing events as novel therapeutic targets and biomarkers. Deciphering this new cryptic code may be a touchstone for ALS and FTD diagnosis and treatment.
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Affiliation(s)
- Tetsuya Akiyama
- Department of Genetics, Stanford University School of Medicine, Stanford, California, USA
| | - Yuka Koike
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, USA
| | | | - Aaron D Gitler
- Department of Genetics, Stanford University School of Medicine, Stanford, California, USA.,Chan Zuckerberg Biohub, San Francisco, California, USA
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15
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Georgakopoulos-Soares I, Parada GE, Wong HY, Medhi R, Furlan G, Munita R, Miska EA, Kwok CK, Hemberg M. Alternative splicing modulation by G-quadruplexes. Nat Commun 2022; 13:2404. [PMID: 35504902 PMCID: PMC9065059 DOI: 10.1038/s41467-022-30071-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 03/30/2022] [Indexed: 12/14/2022] Open
Abstract
Alternative splicing is central to metazoan gene regulation, but the regulatory mechanisms are incompletely understood. Here, we show that G-quadruplex (G4) motifs are enriched ~3-fold near splice junctions. The importance of G4s in RNA is emphasised by a higher enrichment for the non-template strand. RNA-seq data from mouse and human neurons reveals an enrichment of G4s at exons that were skipped following depolarisation induced by potassium chloride. We validate the formation of stable RNA G4s for three candidate splice sites by circular dichroism spectroscopy, UV-melting and fluorescence measurements. Moreover, we find that sQTLs are enriched at G4s, and a minigene experiment provides further support for their role in promoting exon inclusion. Analysis of >1,800 high-throughput experiments reveals multiple RNA binding proteins associated with G4s. Finally, exploration of G4 motifs across eleven species shows strong enrichment at splice sites in mammals and birds, suggesting an evolutionary conserved splice regulatory mechanism. Here the authors shows that G-quadruplexes, non-canonical DNA/RNA structures, can have a direct impact on alternative splicing and that binding of splicing regulators is affected by their presence.
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Affiliation(s)
- Ilias Georgakopoulos-Soares
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK.,Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, CA, 94158, USA
| | - Guillermo E Parada
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK.,Wellcome Cancer Research UK Gurdon Institute, University of Cambridge, Tennis Court Road, Cambridge, CB2 1QN, UK.,Department of Genetics, University of Cambridge, Downing Street, Cambridge, CB2 3EH, UK.,Donnelly Centre for Cellular and Biomolecular Research, University of Toronto, Toronto, ON, M5S 3E1, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, ON, M5A 1A8, Canada
| | - Hei Yuen Wong
- Department of Chemistry and State Key Laboratory of Marine Pollution, City University of Hong Kong, Kowloon Tong, Hong Kong SAR, China
| | - Ragini Medhi
- Wellcome Cancer Research UK Gurdon Institute, University of Cambridge, Tennis Court Road, Cambridge, CB2 1QN, UK.,Department of Genetics, University of Cambridge, Downing Street, Cambridge, CB2 3EH, UK
| | - Giulia Furlan
- Wellcome Cancer Research UK Gurdon Institute, University of Cambridge, Tennis Court Road, Cambridge, CB2 1QN, UK.,Department of Genetics, University of Cambridge, Downing Street, Cambridge, CB2 3EH, UK
| | - Roberto Munita
- Division of Molecular Hematology, Department of Laboratory Medicine, Lund Stem Cell Center, Faculty of Medicine, Lund University, Lund, Sweden
| | - Eric A Miska
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK.,Wellcome Cancer Research UK Gurdon Institute, University of Cambridge, Tennis Court Road, Cambridge, CB2 1QN, UK.,Department of Genetics, University of Cambridge, Downing Street, Cambridge, CB2 3EH, UK
| | - Chun Kit Kwok
- Department of Chemistry and State Key Laboratory of Marine Pollution, City University of Hong Kong, Kowloon Tong, Hong Kong SAR, China.,Shenzhen Research Institute of City University of Hong Kong, Shenzhen, China
| | - Martin Hemberg
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK. .,Wellcome Cancer Research UK Gurdon Institute, University of Cambridge, Tennis Court Road, Cambridge, CB2 1QN, UK. .,Evergrande Center for Immunologic Diseases, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, 02115, USA.
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16
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Brown AL, Wilkins OG, Keuss MJ, Hill SE, Zanovello M, Lee WC, Bampton A, Lee FCY, Masino L, Qi YA, Bryce-Smith S, Gatt A, Hallegger M, Fagegaltier D, Phatnani H, Newcombe J, Gustavsson EK, Seddighi S, Reyes JF, Coon SL, Ramos D, Schiavo G, Fisher EMC, Raj T, Secrier M, Lashley T, Ule J, Buratti E, Humphrey J, Ward ME, Fratta P. TDP-43 loss and ALS-risk SNPs drive mis-splicing and depletion of UNC13A. Nature 2022; 603:131-137. [PMID: 35197628 PMCID: PMC8891020 DOI: 10.1038/s41586-022-04436-3] [Citation(s) in RCA: 160] [Impact Index Per Article: 80.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 01/18/2022] [Indexed: 12/12/2022]
Abstract
Variants of UNC13A, a critical gene for synapse function, increase the risk of amyotrophic lateral sclerosis and frontotemporal dementia1-3, two related neurodegenerative diseases defined by mislocalization of the RNA-binding protein TDP-434,5. Here we show that TDP-43 depletion induces robust inclusion of a cryptic exon in UNC13A, resulting in nonsense-mediated decay and loss of UNC13A protein. Two common intronic UNC13A polymorphisms strongly associated with amyotrophic lateral sclerosis and frontotemporal dementia risk overlap with TDP-43 binding sites. These polymorphisms potentiate cryptic exon inclusion, both in cultured cells and in brains and spinal cords from patients with these conditions. Our findings, which demonstrate a genetic link between loss of nuclear TDP-43 function and disease, reveal the mechanism by which UNC13A variants exacerbate the effects of decreased TDP-43 function. They further provide a promising therapeutic target for TDP-43 proteinopathies.
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Affiliation(s)
- Anna-Leigh Brown
- UCL Queen Square Motor Neuron Disease Centre, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Oscar G Wilkins
- UCL Queen Square Motor Neuron Disease Centre, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, UCL, London, UK
- The Francis Crick Institute, London, UK
| | - Matthew J Keuss
- UCL Queen Square Motor Neuron Disease Centre, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Sarah E Hill
- National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD, USA
| | - Matteo Zanovello
- UCL Queen Square Motor Neuron Disease Centre, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Weaverly Colleen Lee
- UCL Queen Square Motor Neuron Disease Centre, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Alexander Bampton
- Queen Square Brain Bank, UCL Queen Square Institute of Neurology, University College London, London, UK
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Flora C Y Lee
- UCL Queen Square Motor Neuron Disease Centre, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, UCL, London, UK
- The Francis Crick Institute, London, UK
| | | | - Yue A Qi
- Center for Alzheimer's and Related Dementias, National Institutes of Health, Bethesda, MD, USA
| | - Sam Bryce-Smith
- UCL Queen Square Motor Neuron Disease Centre, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Ariana Gatt
- Queen Square Brain Bank, UCL Queen Square Institute of Neurology, University College London, London, UK
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Martina Hallegger
- UCL Queen Square Motor Neuron Disease Centre, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, UCL, London, UK
- The Francis Crick Institute, London, UK
| | - Delphine Fagegaltier
- Center for Genomics of Neurodegenerative Disease, New York Genome Center (NYGC), New York, NY, USA
| | - Hemali Phatnani
- Center for Genomics of Neurodegenerative Disease, New York Genome Center (NYGC), New York, NY, USA
| | - Jia Newcombe
- NeuroResource, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, London, UK
| | - Emil K Gustavsson
- Queen Square Brain Bank, UCL Queen Square Institute of Neurology, University College London, London, UK
- Great Ormond Street Institute of Child Health, Genetics and Genomic Medicine, University College London, London, UK
| | - Sahba Seddighi
- National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD, USA
- Medical Scientist Training Program, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Joel F Reyes
- National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD, USA
| | - Steven L Coon
- Molecular Genomics Core, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD, USA
| | - Daniel Ramos
- National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD, USA
- Center for Alzheimer's and Related Dementias, National Institutes of Health, Bethesda, MD, USA
| | - Giampietro Schiavo
- UCL Queen Square Motor Neuron Disease Centre, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, UCL, London, UK
- UK Dementia Research Institute, University College London, London, UK
| | - Elizabeth M C Fisher
- UCL Queen Square Motor Neuron Disease Centre, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Towfique Raj
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Ronald M. Loeb Center for Alzheimer's Disease, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences and Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Estelle and Daniel Maggin Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Maria Secrier
- Department of Genetics, Evolution and Environment, UCL Genetics Institute, University College London, London, UK
| | - Tammaryn Lashley
- Queen Square Brain Bank, UCL Queen Square Institute of Neurology, University College London, London, UK
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Jernej Ule
- UCL Queen Square Motor Neuron Disease Centre, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, UCL, London, UK
- The Francis Crick Institute, London, UK
- Department of Molecular Biology and Nanobiotechnology, National Institute of Chemistry, Ljubljana, Slovenia
| | - Emanuele Buratti
- Molecular Pathology Lab, International Centre for Genetic Engineering and Biotechnology (ICGEB), Trieste, Italy
| | - Jack Humphrey
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Ronald M. Loeb Center for Alzheimer's Disease, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences and Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Estelle and Daniel Maggin Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michael E Ward
- National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD, USA.
| | - Pietro Fratta
- UCL Queen Square Motor Neuron Disease Centre, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, UCL, London, UK.
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17
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Ma XR, Prudencio M, Koike Y, Vatsavayai SC, Kim G, Harbinski F, Briner A, Rodriguez CM, Guo C, Akiyama T, Schmidt HB, Cummings BB, Wyatt DW, Kurylo K, Miller G, Mekhoubad S, Sallee N, Mekonnen G, Ganser L, Rubien JD, Jansen-West K, Cook CN, Pickles S, Oskarsson B, Graff-Radford NR, Boeve BF, Knopman DS, Petersen RC, Dickson DW, Shorter J, Myong S, Green EM, Seeley WW, Petrucelli L, Gitler AD. TDP-43 represses cryptic exon inclusion in the FTD-ALS gene UNC13A. Nature 2022; 603:124-130. [PMID: 35197626 PMCID: PMC8891019 DOI: 10.1038/s41586-022-04424-7] [Citation(s) in RCA: 173] [Impact Index Per Article: 86.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 01/13/2022] [Indexed: 02/08/2023]
Abstract
A hallmark pathological feature of the neurodegenerative diseases amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) is the depletion of RNA-binding protein TDP-43 from the nucleus of neurons in the brain and spinal cord1. A major function of TDP-43 is as a repressor of cryptic exon inclusion during RNA splicing2-4. Single nucleotide polymorphisms in UNC13A are among the strongest hits associated with FTD and ALS in human genome-wide association studies5,6, but how those variants increase risk for disease is unknown. Here we show that TDP-43 represses a cryptic exon-splicing event in UNC13A. Loss of TDP-43 from the nucleus in human brain, neuronal cell lines and motor neurons derived from induced pluripotent stem cells resulted in the inclusion of a cryptic exon in UNC13A mRNA and reduced UNC13A protein expression. The top variants associated with FTD or ALS risk in humans are located in the intron harbouring the cryptic exon, and we show that they increase UNC13A cryptic exon splicing in the face of TDP-43 dysfunction. Together, our data provide a direct functional link between one of the strongest genetic risk factors for FTD and ALS (UNC13A genetic variants), and loss of TDP-43 function.
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Affiliation(s)
- X Rosa Ma
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | - Mercedes Prudencio
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
- Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL, USA
| | - Yuka Koike
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
- Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL, USA
| | - Sarat C Vatsavayai
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
- Department of Pathology, University of California San Francisco, San Francisco, CA, USA
| | - Garam Kim
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
- Neurosciences Interdepartmental Program, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Adam Briner
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
- Clem Jones Centre for Ageing Dementia Research (CJCADR), Queensland Brain Institute (QBI), The University of Queensland, Brisbane, Queensland, Australia
| | - Caitlin M Rodriguez
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | - Caiwei Guo
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | - Tetsuya Akiyama
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | - H Broder Schmidt
- Department of Biochemistry, Stanford University School of Medicine, Stanford, CA, USA
| | | | | | | | | | | | | | - Gemechu Mekonnen
- Program in Cell, Molecular, Developmental Biology, and Biophysics, Johns Hopkins University, Baltimore, MD, USA
- Department of Biology, Johns Hopkins University, Baltimore, MD, USA
| | - Laura Ganser
- Department of Biophysics, Johns Hopkins University, Baltimore, MD, USA
| | - Jack D Rubien
- Department of Biochemistry and Biophysics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Casey N Cook
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
- Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL, USA
| | - Sarah Pickles
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
- Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL, USA
| | | | | | | | | | | | - Dennis W Dickson
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
- Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL, USA
| | - James Shorter
- Department of Biochemistry and Biophysics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sua Myong
- Program in Cell, Molecular, Developmental Biology, and Biophysics, Johns Hopkins University, Baltimore, MD, USA
- Department of Biology, Johns Hopkins University, Baltimore, MD, USA
- Department of Biophysics, Johns Hopkins University, Baltimore, MD, USA
| | | | - William W Seeley
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
- Department of Pathology, University of California San Francisco, San Francisco, CA, USA
| | - Leonard Petrucelli
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA.
- Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL, USA.
| | - Aaron D Gitler
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA.
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18
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Kocar TD, Müller HP, Ludolph AC, Kassubek J. Feature selection from magnetic resonance imaging data in ALS: a systematic review. Ther Adv Chronic Dis 2021; 12:20406223211051002. [PMID: 34729157 PMCID: PMC8521429 DOI: 10.1177/20406223211051002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 09/15/2021] [Indexed: 12/23/2022] Open
Abstract
Background: With the advances in neuroimaging in amyotrophic lateral sclerosis (ALS), it has been speculated that multiparametric magnetic resonance imaging (MRI) is capable to contribute to early diagnosis. Machine learning (ML) can be regarded as the missing piece that allows for the useful integration of multiparametric MRI data into a diagnostic classifier. The major challenges in developing ML classifiers for ALS are limited data quantity and a suboptimal sample to feature ratio which can be addressed by sound feature selection. Methods: We conducted a systematic review to collect MRI biomarkers that could be used as features by searching the online database PubMed for entries in the recent 4 years that contained cross-sectional neuroimaging data of subjects with ALS and an adequate control group. In addition to the qualitative synthesis, a semi-quantitative analysis was conducted for each MRI modality that indicated which brain regions were most commonly reported. Results: Our search resulted in 151 studies with a total of 221 datasets. In summary, our findings highly resembled generally accepted neuropathological patterns of ALS, with degeneration of the motor cortex and the corticospinal tract, but also in frontal, temporal, and subcortical structures, consistent with the neuropathological four-stage model of the propagation of pTDP-43 in ALS. Conclusions: These insights are discussed with respect to their potential for MRI feature selection for future ML-based neuroimaging classifiers in ALS. The integration of multiparametric MRI including DTI, volumetric, and texture data using ML may be the best approach to generate a diagnostic neuroimaging tool for ALS.
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Affiliation(s)
- Thomas D Kocar
- Department of Neurology, University of Ulm, Ulm, Germany
| | | | - Albert C Ludolph
- Department of Neurology, University of Ulm, Ulm, Germany Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Ulm, Germany
| | - Jan Kassubek
- Department of Neurology, University of Ulm, Oberer Eselsberg 45, 89081 Ulm, Germany
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19
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Placek K, Benatar M, Wuu J, Rampersaud E, Hennessy L, Van Deerlin VM, Grossman M, Irwin DJ, Elman L, McCluskey L, Quinn C, Granit V, Statland JM, Burns TM, Ravits J, Swenson A, Katz J, Pioro EP, Jackson C, Caress J, So Y, Maiser S, Walk D, Lee EB, Trojanowski JQ, Cook P, Gee J, Sha J, Naj AC, Rademakers R, Chen W, Wu G, Paul Taylor J, McMillan CT. Machine learning suggests polygenic risk for cognitive dysfunction in amyotrophic lateral sclerosis. EMBO Mol Med 2021; 13:e12595. [PMID: 33270986 PMCID: PMC7799365 DOI: 10.15252/emmm.202012595] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 10/27/2020] [Accepted: 10/30/2020] [Indexed: 11/09/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a multi-system disease characterized primarily by progressive muscle weakness. Cognitive dysfunction is commonly observed in patients; however, factors influencing risk for cognitive dysfunction remain elusive. Using sparse canonical correlation analysis (sCCA), an unsupervised machine-learning technique, we observed that single nucleotide polymorphisms collectively associate with baseline cognitive performance in a large ALS patient cohort (N = 327) from the multicenter Clinical Research in ALS and Related Disorders for Therapeutic Development (CReATe) Consortium. We demonstrate that a polygenic risk score derived using sCCA relates to longitudinal cognitive decline in the same cohort and also to in vivo cortical thinning in the orbital frontal cortex, anterior cingulate cortex, lateral temporal cortex, premotor cortex, and hippocampus (N = 90) as well as post-mortem motor cortical neuronal loss (N = 87) in independent ALS cohorts from the University of Pennsylvania Integrated Neurodegenerative Disease Biobank. Our findings suggest that common genetic polymorphisms may exert a polygenic contribution to the risk of cortical disease vulnerability and cognitive dysfunction in ALS.
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20
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Placek K, Benatar M, Wuu J, Rampersaud E, Hennessy L, Van Deerlin VM, Grossman M, Irwin DJ, Elman L, McCluskey L, Quinn C, Granit V, Statland JM, Burns TM, Ravits J, Swenson A, Katz J, Pioro EP, Jackson C, Caress J, So Y, Maiser S, Walk D, Lee EB, Trojanowski JQ, Cook P, Gee J, Sha J, Naj AC, Rademakers R, Chen W, Wu G, Paul Taylor J, McMillan CT. Machine learning suggests polygenic risk for cognitive dysfunction in amyotrophic lateral sclerosis. EMBO Mol Med 2021. [PMID: 33270986 PMCID: PMC7799365 DOI: 10.15252/emmm.202012595|] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a multi-system disease characterized primarily by progressive muscle weakness. Cognitive dysfunction is commonly observed in patients; however, factors influencing risk for cognitive dysfunction remain elusive. Using sparse canonical correlation analysis (sCCA), an unsupervised machine-learning technique, we observed that single nucleotide polymorphisms collectively associate with baseline cognitive performance in a large ALS patient cohort (N = 327) from the multicenter Clinical Research in ALS and Related Disorders for Therapeutic Development (CReATe) Consortium. We demonstrate that a polygenic risk score derived using sCCA relates to longitudinal cognitive decline in the same cohort and also to in vivo cortical thinning in the orbital frontal cortex, anterior cingulate cortex, lateral temporal cortex, premotor cortex, and hippocampus (N = 90) as well as post-mortem motor cortical neuronal loss (N = 87) in independent ALS cohorts from the University of Pennsylvania Integrated Neurodegenerative Disease Biobank. Our findings suggest that common genetic polymorphisms may exert a polygenic contribution to the risk of cortical disease vulnerability and cognitive dysfunction in ALS.
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Affiliation(s)
- Katerina Placek
- Department of NeurologyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA
| | - Michael Benatar
- Department of NeurologyLeonard M. Miller School of MedicineUniversity of MiamiMiamiFLUSA
| | - Joanne Wuu
- Department of NeurologyLeonard M. Miller School of MedicineUniversity of MiamiMiamiFLUSA
| | - Evadnie Rampersaud
- Center for Applied BioinformaticsSt. Jude Children’s Research HospitalMemphisTNUSA
| | - Laura Hennessy
- Department of NeurologyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA
| | - Vivianna M Van Deerlin
- Department of Pathology & Laboratory MedicineUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA
| | - Murray Grossman
- Department of NeurologyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA
| | - David J Irwin
- Department of NeurologyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA
| | - Lauren Elman
- Department of NeurologyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA
| | - Leo McCluskey
- Department of NeurologyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA
| | - Colin Quinn
- Department of NeurologyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA
| | - Volkan Granit
- Department of NeurologyLeonard M. Miller School of MedicineUniversity of MiamiMiamiFLUSA
| | - Jeffrey M Statland
- Department of NeurologyUniversity of Kansas Medical CenterKansas CityKSUSA
| | - Ted M Burns
- Department of NeurologyUniversity of Virginia Health SystemCharlottesvilleVAUSA
| | - John Ravits
- Department of NeurosciencesUniversity of California San DiegoSan DiegoCAUSA
| | | | - Jon Katz
- Forbes Norris ALS CenterCalifornia Pacific Medical CenterSan FranciscoCAUSA
| | - Erik P Pioro
- Department of NeurologyCleveland ClinicClevelandOHUSA
| | - Carlayne Jackson
- Department of NeurologyUniversity of Texas Health Science CenterSan AntonioTXUSA
| | - James Caress
- Department of NeurologyWake Forest University School of MedicineWinston‐SalemNCUSA
| | - Yuen So
- Department of NeurologyStanford University Medical CenterSan JoseCAUSA
| | - Samuel Maiser
- Department of NeurologyUniversity of Minnesota Medical CenterMinneapolisMNUSA
| | - David Walk
- Department of NeurologyUniversity of Minnesota Medical CenterMinneapolisMNUSA
| | - Edward B Lee
- Department of Pathology & Laboratory MedicineUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA
| | - John Q Trojanowski
- Department of Pathology & Laboratory MedicineUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA
| | - Philip Cook
- Penn Image Computing Science Laboratory (PICSL)Department of RadiologyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA
| | - James Gee
- Penn Image Computing Science Laboratory (PICSL)Department of RadiologyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA
| | - Jin Sha
- Department of Biostatistics, Epidemiology, and InformaticsUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA,Penn Neurodegeneration Genomics CenterDepartment of Pathology and Laboratory MedicineUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA
| | - Adam C Naj
- Department of Pathology & Laboratory MedicineUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA,Department of Biostatistics, Epidemiology, and InformaticsUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA,Penn Neurodegeneration Genomics CenterDepartment of Pathology and Laboratory MedicineUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA
| | | | | | - Wenan Chen
- Center for Applied BioinformaticsSt. Jude Children’s Research HospitalMemphisTNUSA
| | - Gang Wu
- Center for Applied BioinformaticsSt. Jude Children’s Research HospitalMemphisTNUSA
| | - J Paul Taylor
- Center for Applied BioinformaticsSt. Jude Children’s Research HospitalMemphisTNUSA,The Howard Hughes Medical InstituteChevy ChaseMSUSA
| | - Corey T McMillan
- Department of NeurologyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA
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21
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Kukharsky MS, Skvortsova VI, Bachurin SO, Buchman VL. In a search for efficient treatment for amyotrophic lateral sclerosis: Old drugs for new approaches. Med Res Rev 2020; 41:2804-2822. [DOI: 10.1002/med.21725] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/23/2020] [Accepted: 08/08/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Michail S. Kukharsky
- Faculty of Medical Biology Pirogov Russian National Research Medical University Moscow Russian Federation
- Institute of Physiologically Active Compounds Russian Academy of Sciences Moscow Region Russian Federation
| | - Veronika I. Skvortsova
- Faculty of Medical Biology Pirogov Russian National Research Medical University Moscow Russian Federation
| | - Sergey O. Bachurin
- Institute of Physiologically Active Compounds Russian Academy of Sciences Moscow Region Russian Federation
| | - Vladimir L. Buchman
- Institute of Physiologically Active Compounds Russian Academy of Sciences Moscow Region Russian Federation
- School of Biosciences Cardiff University Cardiff United Kingdom
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22
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Tan HHG, Westeneng HJ, van der Burgh HK, van Es MA, Bakker LA, van Veenhuijzen K, van Eijk KR, van Eijk RPA, Veldink JH, van den Berg LH. The Distinct Traits of the UNC13A Polymorphism in Amyotrophic Lateral Sclerosis. Ann Neurol 2020; 88:796-806. [PMID: 32627229 PMCID: PMC7540607 DOI: 10.1002/ana.25841] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/03/2020] [Accepted: 07/03/2020] [Indexed: 12/11/2022]
Abstract
Objective The rs12608932 single nucleotide polymorphism in UNC13A is associated with amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) susceptibility, and may underlie differences in treatment response. We aimed to characterize the clinical, cognitive, behavioral, and neuroimaging phenotype of UNC13A in patients with ALS. Methods We included 2,216 patients with ALS without a C9orf72 mutation to identify clinical characteristics associated with the UNC13A polymorphism. A subcohort of 428 patients with ALS was used to study cognitive and behavioral profiles, and 375 patients to study neuroimaging characteristics. Associations were analyzed under an additive genetic model. Results Genotyping rs12608932 resulted in 854 A/A, 988 A/C, and 374 C/C genotypes. The C allele was associated with a higher age at symptom onset (median years A/A 63.5, A/C 65.6, and C/C 65.5; p < 0.001), more frequent bulbar onset (A/A 29.6%, A/C 31.8%, and C/C 43.1%; p < 0.001), higher incidences of ALS‐FTD (A/A 4.3%, A/C 5.2%, and C/C 9.5%; p = 0.003), lower forced vital capacity at diagnosis (median percentage A/A 92.0, A/C 90.0, and C/C 86.5; p < 0.001), and a shorter survival (median in months A/A 33.3, A.C 30.7, and C/C 26.6; p < 0.001). UNC13A was associated with lower scores on ALS‐specific cognition tests (means A/A 79.5, A/C 78.1, and C/C 76.6; p = 0.037), and more frequent behavioral disturbances (A/A 16.7%, A/C 24.4%, and C/C 27.7%; p = 0.045). Thinner left inferior temporal and right fusiform cortex were associated with the UNC13A single nucleotide polymorphism (SNP; p = 0.045 and p = 0.036). Interpretation Phenotypical distinctions associated with UNC13A make it an important factor to take into account in clinical trial design, studies on cognition and behavior, and prognostic counseling. ANN NEUROL 2020;88:796–806
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Affiliation(s)
- Harold H G Tan
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Henk-Jan Westeneng
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Hannelore K van der Burgh
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Michael A van Es
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Leonhard A Bakker
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Kevin van Veenhuijzen
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Kristel R van Eijk
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Ruben P A van Eijk
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Biostatistics and Research Support, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Jan H Veldink
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Leonard H van den Berg
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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23
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Guerreiro R, Gibbons E, Tábuas-Pereira M, Kun-Rodrigues C, Santo GC, Bras J. Genetic architecture of common non-Alzheimer's disease dementias. Neurobiol Dis 2020; 142:104946. [PMID: 32439597 PMCID: PMC8207829 DOI: 10.1016/j.nbd.2020.104946] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/04/2020] [Accepted: 05/13/2020] [Indexed: 02/07/2023] Open
Abstract
Frontotemporal dementia (FTD), dementia with Lewy bodies (DLB) and vascular dementia (VaD) are the most common forms of dementia after Alzheimer’s disease (AD). The heterogeneity of these disorders and/or the clinical overlap with other diseases hinder the study of their genetic components. Even though Mendelian dementias are rare, the study of these forms of disease can have a significant impact in the lives of patients and families and have successfully brought to the fore many of the genes currently known to be involved in FTD and VaD, starting to give us a glimpse of the molecular mechanisms underlying these phenotypes. More recently, genome-wide association studies have also pointed to disease risk-associated loci. This has been particularly important for DLB where familial forms of disease are very rarely described. In this review we systematically describe the Mendelian and risk genes involved in these non-AD dementias in an effort to contribute to a better understanding of their genetic architecture, find differences and commonalities between different dementia phenotypes, and uncover areas that would benefit from more intense research endeavors.
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Affiliation(s)
- Rita Guerreiro
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA; Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI, USA.
| | - Elizabeth Gibbons
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA
| | - Miguel Tábuas-Pereira
- Department of Neurology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Celia Kun-Rodrigues
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA
| | - Gustavo C Santo
- Department of Neurology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
| | - Jose Bras
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA; Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI, USA
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Limanaqi F, Biagioni F, Ryskalin L, Busceti CL, Fornai F. Molecular Mechanisms Linking ALS/FTD and Psychiatric Disorders, the Potential Effects of Lithium. Front Cell Neurosci 2019; 13:450. [PMID: 31680867 PMCID: PMC6797817 DOI: 10.3389/fncel.2019.00450] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 09/20/2019] [Indexed: 12/12/2022] Open
Abstract
Altered proteostasis, endoplasmic reticulum (ER) stress, abnormal unfolded protein response (UPR), mitochondrial dysfunction and autophagy impairment are interconnected events, which contribute to the pathogenesis of amyotrophic lateral sclerosis (ALS)/frontotemporal dementia (FTD). In recent years, the mood stabilizer lithium was shown to potentially modify ALS/FTD beyond mood disorder-related pathology. The effects of lithium are significant in ALS patients carrying genetic variations in the UNC13 presynaptic protein, which occur in ALS/FTD and psychiatric disorders as well. In the brain, lithium modulates a number of biochemical pathways involved in synaptic plasticity, proteostasis, and neuronal survival. By targeting UPR-related events, namely ER stress, excitotoxicity and autophagy dysfunction, lithium produces plastic effects. These are likely to relate to neuroprotection, which was postulated for mood and motor neuron disorders. In the present manuscript, we try to identify and discuss potential mechanisms through which lithium copes concomitantly with ER stress, UPR and autophagy dysfunctions related to UNC13 synaptic alterations and aberrant RNA and protein processing. This may serve as a paradigm to provide novel insights into the neurobiology of ALS/FTD featuring early psychiatric disturbances.
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Affiliation(s)
- Fiona Limanaqi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | | | - Larisa Ryskalin
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | | | - Francesco Fornai
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.,IRCCS Neuromed, Pozzilli, Italy
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MicroRNA expression profiles of neuron-derived extracellular vesicles in plasma from patients with amyotrophic lateral sclerosis. Neurosci Lett 2019; 708:134176. [DOI: 10.1016/j.neulet.2019.03.048] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/05/2019] [Accepted: 03/26/2019] [Indexed: 12/13/2022]
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Pottier C, Ren Y, Perkerson RB, Baker M, Jenkins GD, van Blitterswijk M, DeJesus-Hernandez M, van Rooij JGJ, Murray ME, Christopher E, McDonnell SK, Fogarty Z, Batzler A, Tian S, Vicente CT, Matchett B, Karydas AM, Hsiung GYR, Seelaar H, Mol MO, Finger EC, Graff C, Öijerstedt L, Neumann M, Heutink P, Synofzik M, Wilke C, Prudlo J, Rizzu P, Simon-Sanchez J, Edbauer D, Roeber S, Diehl-Schmid J, Evers BM, King A, Mesulam MM, Weintraub S, Geula C, Bieniek KF, Petrucelli L, Ahern GL, Reiman EM, Woodruff BK, Caselli RJ, Huey ED, Farlow MR, Grafman J, Mead S, Grinberg LT, Spina S, Grossman M, Irwin DJ, Lee EB, Suh E, Snowden J, Mann D, Ertekin-Taner N, Uitti RJ, Wszolek ZK, Josephs KA, Parisi JE, Knopman DS, Petersen RC, Hodges JR, Piguet O, Geier EG, Yokoyama JS, Rissman RA, Rogaeva E, Keith J, Zinman L, Tartaglia MC, Cairns NJ, Cruchaga C, Ghetti B, Kofler J, Lopez OL, Beach TG, Arzberger T, Herms J, Honig LS, Vonsattel JP, Halliday GM, Kwok JB, White CL, Gearing M, Glass J, Rollinson S, Pickering-Brown S, Rohrer JD, Trojanowski JQ, Van Deerlin V, Bigio EH, Troakes C, Al-Sarraj S, Asmann Y, Miller BL, Graff-Radford NR, Boeve BF, Seeley WW, Mackenzie IRA, van Swieten JC, Dickson DW, Biernacka JM, Rademakers R. Genome-wide analyses as part of the international FTLD-TDP whole-genome sequencing consortium reveals novel disease risk factors and increases support for immune dysfunction in FTLD. Acta Neuropathol 2019; 137:879-899. [PMID: 30739198 PMCID: PMC6533145 DOI: 10.1007/s00401-019-01962-9] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 01/11/2019] [Accepted: 01/12/2019] [Indexed: 12/12/2022]
Abstract
Frontotemporal lobar degeneration with neuronal inclusions of the TAR DNA-binding protein 43 (FTLD-TDP) represents the most common pathological subtype of FTLD. We established the international FTLD-TDP whole-genome sequencing consortium to thoroughly characterize the known genetic causes of FTLD-TDP and identify novel genetic risk factors. Through the study of 1131 unrelated Caucasian patients, we estimated that C9orf72 repeat expansions and GRN loss-of-function mutations account for 25.5% and 13.9% of FTLD-TDP patients, respectively. Mutations in TBK1 (1.5%) and other known FTLD genes (1.4%) were rare, and the disease in 57.7% of FTLD-TDP patients was unexplained by the known FTLD genes. To unravel the contribution of common genetic factors to the FTLD-TDP etiology in these patients, we conducted a two-stage association study comprising the analysis of whole-genome sequencing data from 517 FTLD-TDP patients and 838 controls, followed by targeted genotyping of the most associated genomic loci in 119 additional FTLD-TDP patients and 1653 controls. We identified three genome-wide significant FTLD-TDP risk loci: one new locus at chromosome 7q36 within the DPP6 gene led by rs118113626 (p value = 4.82e - 08, OR = 2.12), and two known loci: UNC13A, led by rs1297319 (p value = 1.27e - 08, OR = 1.50) and HLA-DQA2 led by rs17219281 (p value = 3.22e - 08, OR = 1.98). While HLA represents a locus previously implicated in clinical FTLD and related neurodegenerative disorders, the association signal in our study is independent from previously reported associations. Through inspection of our whole-genome sequence data for genes with an excess of rare loss-of-function variants in FTLD-TDP patients (n ≥ 3) as compared to controls (n = 0), we further discovered a possible role for genes functioning within the TBK1-related immune pathway (e.g., DHX58, TRIM21, IRF7) in the genetic etiology of FTLD-TDP. Together, our study based on the largest cohort of unrelated FTLD-TDP patients assembled to date provides a comprehensive view of the genetic landscape of FTLD-TDP, nominates novel FTLD-TDP risk loci, and strongly implicates the immune pathway in FTLD-TDP pathogenesis.
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Affiliation(s)
- Cyril Pottier
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Yingxue Ren
- Department of Health Sciences Research, Mayo Clinic, Jacksonville, FL, USA
| | - Ralph B Perkerson
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Matt Baker
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Gregory D Jenkins
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Marka van Blitterswijk
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | | | - Jeroen G J van Rooij
- Department of Neurology, Erasmus Medical Center, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands
| | - Melissa E Murray
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Elizabeth Christopher
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | | | - Zachary Fogarty
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Anthony Batzler
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Shulan Tian
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Cristina T Vicente
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Billie Matchett
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Anna M Karydas
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, CA, USA
| | - Ging-Yuek Robin Hsiung
- Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC, V6T 2B5, Canada
| | - Harro Seelaar
- Department of Neurology, Erasmus Medical Center, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands
| | - Merel O Mol
- Department of Neurology, Erasmus Medical Center, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands
| | - Elizabeth C Finger
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, N6A 2E2, Canada
| | - Caroline Graff
- Division of Neurogeriatrics, Department NVS, Karolinska Institutet, Visionsgatan 4, J10:20, 171 64, Solna, Sweden
- Theme Aging, Unit for Hereditary Dementias, Karolinska University Hospital, Solna, Sweden
| | - Linn Öijerstedt
- Division of Neurogeriatrics, Department NVS, Karolinska Institutet, Visionsgatan 4, J10:20, 171 64, Solna, Sweden
- Theme Aging, Unit for Hereditary Dementias, Karolinska University Hospital, Solna, Sweden
| | - Manuela Neumann
- German Center for Neurodegenerative Diseases (DZNE), 18147, Rostock, Germany
- Department of Neuropathology, University of Tübingen, 72076, Tübingen, Germany
| | - Peter Heutink
- German Center for Neurodegenerative Diseases (DZNE), 18147, Rostock, Germany
- Hertie Institute for Clinical Brain Research, University of Tübingen, 72076, Tübingen, Germany
| | - Matthis Synofzik
- German Center for Neurodegenerative Diseases (DZNE), 18147, Rostock, Germany
- Hertie Institute for Clinical Brain Research, University of Tübingen, 72076, Tübingen, Germany
| | - Carlo Wilke
- German Center for Neurodegenerative Diseases (DZNE), 18147, Rostock, Germany
- Hertie Institute for Clinical Brain Research, University of Tübingen, 72076, Tübingen, Germany
| | - Johannes Prudlo
- German Center for Neurodegenerative Diseases (DZNE), 18147, Rostock, Germany
- Department of Neurology, Rostock University Medical Center, 18147, Rostock, Germany
| | - Patrizia Rizzu
- German Center for Neurodegenerative Diseases (DZNE), 18147, Rostock, Germany
| | - Javier Simon-Sanchez
- German Center for Neurodegenerative Diseases (DZNE), 18147, Rostock, Germany
- Hertie Institute for Clinical Brain Research, University of Tübingen, 72076, Tübingen, Germany
| | - Dieter Edbauer
- German Center for Neurodegenerative Diseases (DZNE), Feodor-Lynen-Str 17, 81377, Munich, Germany
- Munich Cluster of Systems Neurology (SyNergy), Feodor-Lynen-Str 17, 81377, Munich, Germany
| | - Sigrun Roeber
- Center for Neuropathology and Prion Research, Ludwig-Maximilians-University of Munich, Feodor-Lynen-Straße 23, 81377, Munich, Germany
| | - Janine Diehl-Schmid
- Department of Psychiatry and Psychotherapy, Technische Universität München, Munich, Germany
| | - Bret M Evers
- Division of Neuropathology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9073, USA
| | - Andrew King
- London Neurodegenerative Diseases Brain Bank, Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
- Department of Clinical Neuropathology, King's College Hospital NHS Foundation Trust, London, SE5 9RS, UK
| | - M Marsel Mesulam
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University, Chicago, IL, 60611, USA
| | - Sandra Weintraub
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University, Chicago, IL, 60611, USA
- Department of Psychiatry and Behavioral Sciences and Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Changiz Geula
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University, Chicago, IL, 60611, USA
| | - Kevin F Bieniek
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio, San Antonio, TX, 78229, USA
| | - Leonard Petrucelli
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Geoffrey L Ahern
- Department of Neurology, University of Arizona Health Sciences Center, 1501 North Campbell Avenue, Tucson, AZ, 85724-5023, USA
| | - Eric M Reiman
- Banner Alzheimer's Institute, Phoenix, AZ, 85006, USA
| | - Bryan K Woodruff
- Department of Neurology, Mayo Clinic Arizona, Scottsdale, AZ, 85259, USA
| | - Richard J Caselli
- Department of Neurology, Mayo Clinic Arizona, Scottsdale, AZ, 85259, USA
| | - Edward D Huey
- Departments of Psychiatry and Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, 630 West 168th St P&S Box 16, New York, NY, 10032, USA
| | - Martin R Farlow
- Indiana University School of Medicine, 355 West 16th Street, GH 4700 Neurology, Indianapolis, IN, 46202, USA
| | - Jordan Grafman
- Department of Physical Medicine and Rehabilitation, Neurology, Cognitive Neurology and Alzheimer's Center, Department of Psychiatry, Feinberg School of Medicine, Northwestern University, 355 E Erie Street, Chicago, IL, 60611-5146, USA
| | - Simon Mead
- MRC Prion Unit at University College London, Institute of Prion Diseases, London, UK
| | - Lea T Grinberg
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, CA, USA
- Department of Pathology, Memory and Aging Center, University of California, San Francisco, CA, USA
| | - Salvatore Spina
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, CA, USA
| | - Murray Grossman
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - David J Irwin
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Edward B Lee
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - EunRan Suh
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Julie Snowden
- Cerebral Function Unit, Greater Manchester Neurosciences Centre, Salford Royal Hospital, Salford, UK
| | - David Mann
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Salford Royal Hospital, Salford, UK
| | - Nilufer Ertekin-Taner
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - Ryan J Uitti
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | | | | | | | | | | | - John R Hodges
- Central Clinical School and Brain and Mind Centre, The University of Sydney, Sydney, 2050, Australia
| | - Olivier Piguet
- School of Psychology and Brain and Mind Centre, The University of Sydney, Sydney, 2050, Australia
| | - Ethan G Geier
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, CA, USA
| | - Jennifer S Yokoyama
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, CA, USA
| | - Robert A Rissman
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, 92093, USA
- Veterans Affairs San Diego Healthcare System, San Diego, CA, 92161, USA
| | - Ekaterina Rogaeva
- Krembil Discovery Tower, Tanz Centre for Research in Neurodegenerative Disease, University of Toronto, 60 Leonard Av, 4th Floor - 4KD481, Toronto, ON, M5T 0S8, Canada
| | - Julia Keith
- Sunnybrook Health Sciences Centre, Toronto, ON, M4N 3M5, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, M5S 1A1, Canada
| | - Lorne Zinman
- Sunnybrook Health Sciences Centre, Toronto, ON, M4N 3M5, Canada
| | - Maria Carmela Tartaglia
- Krembil Discovery Tower, Tanz Centre for Research in Neurodegenerative Disease, University of Toronto, 60 Leonard Av, 4th Floor - 4KD481, Toronto, ON, M5T 0S8, Canada
- Krembil Neuroscience Center, Movement Disorder's Clinic, Toronto Western Hospital, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada
| | - Nigel J Cairns
- Department of Neurology, Knight Alzheimer Disease Research Center, Washington University School of Medicine, Saint Louis, MO, 63108, USA
| | - Carlos Cruchaga
- Department of Psychiatry, Knight Alzheimer Disease Research Center, Washington University School of Medicine, Saint Louis, MO, 63108, USA
| | - Bernardino Ghetti
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, 635 Barnhill Drive, MS A138, Indianapolis, IN, 46202, USA
| | - Julia Kofler
- Department of Pathology, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Oscar L Lopez
- Department of Neurology, University of Arizona Health Sciences Center, 1501 North Campbell Avenue, Tucson, AZ, 85724-5023, USA
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Thomas G Beach
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, AZ, 85351, USA
| | - Thomas Arzberger
- German Center for Neurodegenerative Diseases (DZNE), Feodor-Lynen-Str 17, 81377, Munich, Germany
- Center for Neuropathology and Prion Research, Ludwig-Maximilians-University of Munich, Feodor-Lynen-Straße 23, 81377, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University of Munich, Nussbaumstraße 7, 80336, Munich, Germany
| | - Jochen Herms
- German Center for Neurodegenerative Diseases (DZNE), Feodor-Lynen-Str 17, 81377, Munich, Germany
- Center for Neuropathology and Prion Research, Ludwig-Maximilians-University of Munich, Feodor-Lynen-Straße 23, 81377, Munich, Germany
| | - Lawrence S Honig
- Department of Neurology, Taub Institute, and GH Sergievsky Center, Columbia University Irving Medical Center, 630 West 168th St (P&S Unit 16), New York, NY, 10032, USA
| | - Jean Paul Vonsattel
- Department of Pathology and Taub Institute, Columbia University Irving Medical Center, 630 West 168th St, New York, NY, 10032, USA
| | - Glenda M Halliday
- Central Clinical School and Brain and Mind Centre, The University of Sydney, Sydney, 2050, Australia
- UNSW Medicine and NeuRA, Randwick, 2031, Australia
| | - John B Kwok
- Central Clinical School and Brain and Mind Centre, The University of Sydney, Sydney, 2050, Australia
- UNSW Medicine and NeuRA, Randwick, 2031, Australia
| | - Charles L White
- Division of Neuropathology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9073, USA
| | - Marla Gearing
- Department of Pathology and Laboratory Medicine and Department of Neurology, Emory University, Atlanta, GA, 30322, USA
| | - Jonathan Glass
- Department of Pathology and Laboratory Medicine and Department of Neurology, Emory University, Atlanta, GA, 30322, USA
| | - Sara Rollinson
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Stuart Pickering-Brown
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - John Q Trojanowski
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Vivianna Van Deerlin
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Eileen H Bigio
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University, Chicago, IL, 60611, USA
| | - Claire Troakes
- London Neurodegenerative Diseases Brain Bank, Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Safa Al-Sarraj
- London Neurodegenerative Diseases Brain Bank, Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
- Department of Clinical Neuropathology, King's College Hospital NHS Foundation Trust, London, SE5 9RS, UK
| | - Yan Asmann
- Department of Health Sciences Research, Mayo Clinic, Jacksonville, FL, USA
| | - Bruce L Miller
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, CA, USA
| | | | | | - William W Seeley
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, CA, USA
- Department of Pathology, Memory and Aging Center, University of California, San Francisco, CA, USA
| | - Ian R A Mackenzie
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, V5Z 1M9, Canada
| | - John C van Swieten
- Department of Neurology, Erasmus Medical Center, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands
| | - Dennis W Dickson
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | | | - Rosa Rademakers
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.
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Galimberti D. Genetic risk factors and role of immune dysfunction in FTLD. Nat Rev Neurol 2019; 15:250-251. [DOI: 10.1038/s41582-019-0173-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Grossman M. Amyotrophic lateral sclerosis — a multisystem neurodegenerative disorder. Nat Rev Neurol 2018; 15:5-6. [DOI: 10.1038/s41582-018-0103-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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