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Borghero G, Pierri V, Pili F, Muroni A, Ercoli T, Pateri MI, Pilotto S, Maccabeo A, Chiò A, Defazio G. Percutaneous gastrostomy, mechanical ventilation and survival in amyotrophic lateral sclerosis: an observational study in an incident cohort. Amyotroph Lateral Scler Frontotemporal Degener 2024; 25:563-569. [PMID: 38747354 DOI: 10.1080/21678421.2024.2351185] [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: 01/16/2024] [Revised: 04/24/2024] [Accepted: 04/29/2024] [Indexed: 07/25/2024]
Abstract
OBJECTIVE To analyze disease-modifying effects of percutaneous endoscopic gastrostomy (PEG) insertion for supporting nutrition, noninvasive ventilation (NIV), and tracheostomy-assisted ('invasive') ventilation (TIV) in amyotrophic lateral sclerosis (ALS). METHODS We retrospectively analyzed survival in a large population-based incident cohort that was prospectively followed up in our center. Analysis considered several known ALS-related prognostic variables. RESULTS In this population, PEG and NIV in multivariable analysis significantly correlated to survival as computed by disease onset to death/tracheostomy. NIV was associated with better survival while PEG was associated with reduced survival. Other independent prognostic factors were age at ALS onset, diagnostic delay, and flail arm/leg and pure upper motor neuron (PUMN) phenotypes. The length of survival after TIV was significantly associated with age at ALS onset (inverse correlation) whereas other variables did not. The length of survival after TIV correlated to age at ALS onset in such a way that each additional year of age at ALS onset decreased survival by about 0.7 months. Patients who underwent both TIV and NIV did not experience a better survival than those who underwent TIV alone. CONCLUSION The lack of effect of enteral nutrition on ALS survival probably reflected the timing of PEG insertion in patients with more severe disease. By contrast, patients who used mechanical ventilation had an increased overall survival compared with non-ventilated ones. The study also provided new information showing that the combined use of NIV and TIV did not may prolong ALS survival as compared to TIV alone.
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Affiliation(s)
- Giuseppe Borghero
- Institute of Neurology, Azienda Ospedaliero Universitaria di Cagliari, Italy
| | - Vincenzo Pierri
- Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - Francesca Pili
- Institute of Neurology, Azienda Ospedaliero Universitaria di Cagliari, Italy
| | - Antonella Muroni
- Institute of Neurology, Azienda Ospedaliero Universitaria di Cagliari, Italy
| | - Tommaso Ercoli
- Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - Maria Ida Pateri
- Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - Silvy Pilotto
- Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - Alessandra Maccabeo
- Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - Adriano Chiò
- Rita Levi Montalcini Department of Neurosciences, ALS Center, University of Turin, Turin, Italy, and
| | - Giovanni Defazio
- Institute of Neurology, Azienda Ospedaliero Universitaria di Cagliari, Italy
- Department of Translational Biomedicine and Neurosciences, University of Bari "Aldo Moro", Italy
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Lépine S, Nauleau-Javaudin A, Deneault E, Chen CXQ, Abdian N, Franco-Flores AK, Haghi G, Castellanos-Montiel MJ, Maussion G, Chaineau M, Durcan TM. Homozygous ALS-linked mutations in TARDBP/TDP-43 lead to hypoactivity and synaptic abnormalities in human iPSC-derived motor neurons. iScience 2024; 27:109166. [PMID: 38433895 PMCID: PMC10905001 DOI: 10.1016/j.isci.2024.109166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/21/2023] [Accepted: 02/05/2024] [Indexed: 03/05/2024] Open
Abstract
Cytoplasmic mislocalization and aggregation of the RNA-binding protein TDP-43 is a pathological hallmark of the motor neuron (MN) disease amyotrophic lateral sclerosis (ALS). Furthermore, while mutations in TARDBP (encoding TDP-43) have been associated with ALS, the pathogenic consequences of these mutations remain poorly understood. Using CRISPR-Cas9, we engineered two homozygous knock-in induced pluripotent stem cell lines carrying mutations in TARDBP encoding TDP-43A382T and TDP-43G348C, two common yet understudied ALS TDP-43 variants. Motor neurons (MNs) differentiated from knock-in iPSCs had normal viability and displayed no significant changes in TDP-43 subcellular localization, phosphorylation, solubility, or aggregation compared with isogenic control MNs. However, our results highlight synaptic impairments in both TDP-43A382T and TDP-43G348C MN cultures, as reflected in synapse abnormalities and alterations in spontaneous neuronal activity. Collectively, our findings suggest that MN dysfunction may precede the occurrence of TDP-43 pathology and neurodegeneration in ALS and further implicate synaptic and excitability defects in the pathobiology of this disease.
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Affiliation(s)
- Sarah Lépine
- Early Drug Discovery Unit (EDDU), The Neuro-Montreal Neurological Institute and Hospital, Department of Neurology and Neurosurgery, McGill University, Montreal, QC H3A 1A1, Canada
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H3G 2M1, Canada
| | - Angela Nauleau-Javaudin
- Early Drug Discovery Unit (EDDU), The Neuro-Montreal Neurological Institute and Hospital, Department of Neurology and Neurosurgery, McGill University, Montreal, QC H3A 1A1, Canada
- Faculty of Medicine, Université de Montréal, Montreal, QC H3C 3J7, Canada
| | - Eric Deneault
- Centre for Oncology, Radiopharmaceuticals and Research; Biologic and Radiopharmaceutical Drugs Directorate, Health Products and Food Branch, Health Canada, Ottawa, ON K1A 0K9, Canada
| | - Carol X.-Q. Chen
- Early Drug Discovery Unit (EDDU), The Neuro-Montreal Neurological Institute and Hospital, Department of Neurology and Neurosurgery, McGill University, Montreal, QC H3A 1A1, Canada
| | - Narges Abdian
- Early Drug Discovery Unit (EDDU), The Neuro-Montreal Neurological Institute and Hospital, Department of Neurology and Neurosurgery, McGill University, Montreal, QC H3A 1A1, Canada
| | - Anna Krystina Franco-Flores
- Early Drug Discovery Unit (EDDU), The Neuro-Montreal Neurological Institute and Hospital, Department of Neurology and Neurosurgery, McGill University, Montreal, QC H3A 1A1, Canada
| | - Ghazal Haghi
- Early Drug Discovery Unit (EDDU), The Neuro-Montreal Neurological Institute and Hospital, Department of Neurology and Neurosurgery, McGill University, Montreal, QC H3A 1A1, Canada
| | - María José Castellanos-Montiel
- Early Drug Discovery Unit (EDDU), The Neuro-Montreal Neurological Institute and Hospital, Department of Neurology and Neurosurgery, McGill University, Montreal, QC H3A 1A1, Canada
| | - Gilles Maussion
- Early Drug Discovery Unit (EDDU), The Neuro-Montreal Neurological Institute and Hospital, Department of Neurology and Neurosurgery, McGill University, Montreal, QC H3A 1A1, Canada
| | - Mathilde Chaineau
- Early Drug Discovery Unit (EDDU), The Neuro-Montreal Neurological Institute and Hospital, Department of Neurology and Neurosurgery, McGill University, Montreal, QC H3A 1A1, Canada
| | - Thomas Martin Durcan
- Early Drug Discovery Unit (EDDU), The Neuro-Montreal Neurological Institute and Hospital, Department of Neurology and Neurosurgery, McGill University, Montreal, QC H3A 1A1, Canada
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Moglia C, Calvo A, Canosa A, Manera U, Vasta R, Di Pede F, Daviddi M, Matteoni E, Brunetti M, Sbaiz L, Cabras S, Gallone S, Grassano M, Peotta L, Palumbo F, Mora G, Iazzolino B, Chio A. Cognitive and Behavioral Features of Patients With Amyotrophic Lateral Sclerosis Who Are Carriers of the TARDBP Pathogenic Variant. Neurology 2024; 102:e208082. [PMID: 38261982 PMCID: PMC10962913 DOI: 10.1212/wnl.0000000000208082] [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: 08/28/2023] [Accepted: 10/26/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND AND OBJECTIVES TARDBP patients are considered particularly prone to cognitive involvement, but no systematic studies of cognitive impairment in TARDBP patients are available. The aim of this article was to depict in depth the cognitive-behavioral characteristics of a cohort of patients with amyotrophic lateral sclerosis (ALS) carrying TARDBP pathogenetic variants followed by an ALS referral center. METHODS We enrolled all patients with ALS seen at the Turin ALS expert center in the 2009-2021 period who underwent extensive genetic testing and a neuropsychological battery encompassing executive function, verbal memory, language, visual memory, visuoconstructive abilities, attention/working memory, psychomotor speed, nonverbal intelligence, cognitive flexibility, social cognition, and behavior. Tests were compared with the Mann-Whitney U test on age-corrected, sex-corrected, and education-corrected scores. Cognition was classified as normal (ALS-CN); isolated cognitive impairment (ALSci), that is, evidence of executive and/or language dysfunction; isolated behavioral impairment (ALSbi), that is, identification of apathy; cognitive and behavioral impairment (ALScbi), that is, evidence meeting the criteria for both ALSci and ALSbi; and frontotemporal dementia (ALS-FTD). RESULTS This study includes 33 patients with TARDBP pathogenetic variants (TARDBP-ALS) (median age 61 years [interquartile range (IQR) 53-67], 8 female [24.2%]) and 928 patients with ALS not carrying the pathogenic variant (WT-ALS) (median age 67 years [IQR 59-74], 386 female [41.6%]). TARDBP-ALS cases were also compared with 129 matched controls (median age 66 years [IQR 57.5-71.5], 55 female [42.6%]). TARDBP-ALS and WT-ALS patients were cognitively classified as ALS-CN (54% vs 58.8%, respectively), ALSci (21.2% vs 18.3%), ALSci (9.1% vs 9.5%), ALScbi (6.1% vs 6.0%), and ALS-FTD (9.1 vs 6.7%), with no significant difference (p = 0.623). Compared with controls, TARDBP-ALS had a worse performance in executive functions, visual memory, visuoconstructive abilities, verbal fluency, and the apathy behavioral component of FrSBe. The scores of performed tests, including all Edinburgh Cognitive and Behavioral ALS Screen subdomains, were similar in TARDBP-ALS and WT-ALS. DISCUSSION TARDBP-ALS patients were significantly more impaired than controls in most examined domains but do not show any specific pattern of cognitive impairment compared with WT-ALS. Our findings are relevant both clinically, considering the effect of cognitive impairment on patients' decision-making and caregivers' burden, and in designing clinical trials for the treatment of patients carrying TARDBP pathogenetic variants.
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Affiliation(s)
- Cristina Moglia
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
| | - Andrea Calvo
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
| | - Antonio Canosa
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
| | - Umberto Manera
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
| | - Rosario Vasta
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
| | - Francesca Di Pede
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
| | - Margherita Daviddi
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
| | - Enrico Matteoni
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
| | - Maura Brunetti
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
| | - Luca Sbaiz
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
| | - Sara Cabras
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
| | - Salvatore Gallone
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
| | - Maurizio Grassano
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
| | - Laura Peotta
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
| | - Francesca Palumbo
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
| | - Gabriele Mora
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
| | - Barbara Iazzolino
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
| | - Adriano Chio
- From the Rita Levi Montalcini' Department of Neuroscience (C.M., A. Calvo, A. Canosa, U.M., R.V., F.D.P., M.D., E.M., M.B., S.C., M.G., L.P., F.F.P., G.M., B.I., A. Chio), University of Torino; Neurology 1 (C.M., A. Calvo, A. Canosa, U.M., L.S., S.G., A. Chio), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino; and Institute of Cognitive Sciences and Technologies (A. Canosa, A. Chio), National Research Council, Rome, Italy
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Borghero G, Pili F, Muroni A, Ercoli T, Pateri MI, Pilotto S, Maccabeo A, Defazio G. Disease survival and progression in TARDBP ALS patients from Sardinia, Italy. J Neurol 2024; 271:929-934. [PMID: 37855870 DOI: 10.1007/s00415-023-12037-x] [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: 07/08/2023] [Revised: 09/28/2023] [Accepted: 09/29/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Common genes implicated in amyotrophic lateral sclerosis (ALS) development may also influence its progression rate. The C9orf72 mutations featured a faster progression rate while the European SOD1 mutations were associated with a slower progression. In this study, we assessed the relationship between TARDBP and ALS progression/survival. METHODS ALS incident patients (2010-2019) were diagnosed by El Escorial revised criteria and staged over the disease course by the King's staging system. Disease progression was analysed by Kaplan-Meier survival curves and Cox regression models, with survival measured from symptom onset to death/tracheostomy or censor date. RESULTS The study population included 76 patients carrying TARDBP mutations (A382T/G295S), 28 patients carrying the C9orf72 GGGGCC expansion, and 158 patients who had no evidence of causative genetic mutations (nmALS group). TARDBP patients reached death/tracheostomy later than C9orf72 and nmALS patients, independently of possible prognostic indicators (sex, age at ALS onset, diagnostic delay, phenotype at onset, and family history of ALS). On King's staging, the time elapsed between disease onset (King's stage 1) and involvement of the second body region (King's stage 2B) was similar in TARDBP and nmALS patients but longer in TARDBP than in C9orf72 patients. TARDBP patients reached King's stages 3 and 4 later than C9orf72 and nmALS patients. CONCLUSIONS TARDBP patients have a better survival/prognosis than C9orf72-positive and nmALS patients. King's staging also suggested that the higher survival rate and the slower progression associated with the TARDBP mutation could mainly be attributed to the longer time elapsed between King's stages 2B to 3.
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Affiliation(s)
- Giuseppe Borghero
- Institute of Neurology, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy
| | - Francesca Pili
- Institute of Neurology, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy
| | - Antonella Muroni
- Institute of Neurology, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy.
| | - Tommaso Ercoli
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Maria Ida Pateri
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Silvy Pilotto
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Alessandra Maccabeo
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Giovanni Defazio
- Institute of Neurology, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy
- Department of Translational Biomedicine and Neurosciences, University of Bari "Aldo Moro", Bari, Italy
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5
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Borghero G, Sechi MM, Vasta R, Pierri V, Pili F, Pateri I, Pilotto S, Ercoli T, Muroni A, Chiò A, Defazio G. Spatial clustering of amyotrophic lateral sclerosis in Sardinia, Italy: The contribution of age, sex, and genetic factors. Muscle Nerve 2023; 68:323-328. [PMID: 37466098 DOI: 10.1002/mus.27939] [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: 02/25/2023] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 07/20/2023]
Abstract
INTRODUCTION/AIMS Several microgeographic clusters of higher/lower incidence of amyotrophic lateral sclerosis (ALS) have been identified worldwide. Differences in the distribution of local factors were proposed to explain the excess ALS risk, whereas the contribution of known genetic/epigenetic factors remains unclear. The aim is to identify restricted areas of higher risk in Sardinia and to assess whether age, sex, and the most common causative genetic mutations in Sardinia (C9orf72 and TARDBP mutations) contributed to the variation in the ALS risk. METHODS We performed an ad hoc analysis of the 10-y population-based incident cohort of ALS cases from a recent study of a large Sardinian area. Cluster analysis was performed by age- and sex-adjusted Kulldorff's spatial scan statistic. RESULTS We identified a statistically significant cluster of higher ALS incidence in a relatively large area including 34 municipalities and >100,000 individuals. The investigated genetic mutations were more frequent in the cluster area than outside. Regardless of the genetic mutations, the excess of ALS risk was significantly associated with either sex or with age ≥ 65 y. Finally, an additive interaction between older age and male sex contributed to the excess of ALS risk in the cluster area but not outside. DISCUSSION Our analysis demonstrated that known genetic factors, age, and sex may contribute to microgeographic variation in ALS incidence. The significant additive interaction between older age and male sex we found in the high-incidence cluster could suggest the presence of a third factor connecting the analyzed risk factors.
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Affiliation(s)
- Giuseppe Borghero
- Institute of Neurology, University Hospital of Cagliari, Cagliari, Italy
| | - Maria Margherita Sechi
- Institute of Neurology, University Hospital of Cagliari, Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Rosario Vasta
- Amyotrophic Lateral Sclerosis Center, University of Turin, Turin, Italy
| | - Vincenzo Pierri
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Francesca Pili
- Institute of Neurology, University Hospital of Cagliari, Cagliari, Italy
| | - Ida Pateri
- Institute of Neurology, University Hospital of Cagliari, Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Silvy Pilotto
- Institute of Neurology, University Hospital of Cagliari, Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Tommaso Ercoli
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Antonella Muroni
- Institute of Neurology, University Hospital of Cagliari, Cagliari, Italy
| | - Adriano Chiò
- Amyotrophic Lateral Sclerosis Center, University of Turin, Turin, Italy
| | - Giovanni Defazio
- Institute of Neurology, University Hospital of Cagliari, Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Amyotrophic Lateral Sclerosis Center, University of Cagliari, Cagliari, Italy
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6
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Pateri MI, Pilotto S, Borghero G, Pili F, Pierri V, Ercoli T, Gigante AF, Muroni A, Defazio G. Increasing prevalence 2015-2019 of amyotrophic lateral sclerosis in Sardinia, Italy. Neurol Sci 2023:10.1007/s10072-023-06753-5. [PMID: 36964314 DOI: 10.1007/s10072-023-06753-5] [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: 01/21/2023] [Accepted: 03/12/2023] [Indexed: 03/26/2023]
Abstract
BACKGROUND While amyotrophic lateral sclerosis (ALS) incidence has increased during the last decades, structured evidence on increased prevalence is lacking. After reporting a significant yearly increase of ALS incidence over a 10-year period, we checked for increased prevalence in Southern Sardinia over a quinquennium. METHODS ALS patients (El Escorial Criteria) recruited from the study area and followed at ALS Centre, University of Cagliari, were included. Prevalence was computed for January 1, 2015 and January 1, 2019 and was calculated for the overall ALS population as well as for tracheostomized and non-tracheostomized patients. RESULTS We observed a non-significant trend for greater ALS prevalence in 2019 than in 2015 (18.31 per 100,000 vs. 15.26 per 100,000; rate ratio: 1.83, p = 0.01). By contrast, a significantly raising 2015 to 2019 ALS prevalence was observed in tracheostomized patients. No significant difference could be detected in non-tracheostomized. CONCLUSIONS We provided the highest prevalence rate to date reported in the worldwide literature, and also showed a non-significant raising ALS prevalence in the Sardinian population over a quinquennium. The trend in raising ALS prevalence was likely due to extended survival due to invasive interventions.
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Affiliation(s)
- Maria Ida Pateri
- Institute of Neurology, University Hospital of Cagliari, Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Silvy Pilotto
- Institute of Neurology, University Hospital of Cagliari, Cagliari, Italy.
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
| | - Giuseppe Borghero
- Institute of Neurology, University Hospital of Cagliari, Cagliari, Italy
| | - Francesca Pili
- Institute of Neurology, University Hospital of Cagliari, Cagliari, Italy
| | - Vincenzo Pierri
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Tommaso Ercoli
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Antonella Muroni
- Institute of Neurology, University Hospital of Cagliari, Cagliari, Italy
| | - Giovanni Defazio
- Institute of Neurology, University Hospital of Cagliari, Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Amyotrophic Lateral Sclerosis Centre, University of Cagliari, Cagliari, Italy
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7
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Genetic landscape of ALS in Malta based on a quinquennial analysis. Neurobiol Aging 2023; 123:200-207. [PMID: 36549973 DOI: 10.1016/j.neurobiolaging.2022.11.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/02/2022] [Accepted: 11/17/2022] [Indexed: 11/24/2022]
Abstract
Genetic risk for amyotrophic lateral sclerosis (ALS) is highly elevated in genetic isolates, like the island population of Malta in the south of Europe, providing a unique opportunity to investigate the genetics of this disease. Here we characterize the clinical phenotype and genetic profile of the largest series of Maltese ALS patients to date identified throughout a 5-year window. Cases and controls underwent neuromuscular assessment and analysis of rare variants in ALS causative or risk genes following whole-genome sequencing. Potentially damaging variants or repeat expansions were identified in more than 45% of all patients. The most commonly affected genes were ALS2, DAO, SETX and SPG11, an infrequent cause of ALS in Europeans. We also confirmed a significant association between ATXN1 intermediate repeats and increased disease risk. Damaging variants in major ALS genes C9orf72, SOD1, TARDBP and FUS were however either absent or rare in Maltese ALS patients. Overall, our study underscores a population that is an outlier within Europe and one that represents a high percentage of genetically explained cases.
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8
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Pierri V, Borghero G, Pili F, Ercoli T, Gigante AF, Lecca LI, Vasta R, Campagna M, Chiò A, Defazio G. Impact of occupational categories on the incidence of amyotrophic lateral sclerosis in Sardinia Island, Italy. Amyotroph Lateral Scler Frontotemporal Degener 2022; 24:212-218. [PMID: 36476139 DOI: 10.1080/21678421.2022.2153606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Occupation is one of the potential risk factors for amyotrophic lateral sclerosis (ALS) for which previous controlled studies produced inconsistent results. The aim of this study is to assess the impact of several groups of occupational categories on ALS incidence. METHODS ALS patients from the southern part of Sardinia who had onset during 2012-2021 and fulfilled El Escorial revised diagnostic criteria were included. The risk of ALS was estimated in relation to the occupation held in 2011, as obtained from the 2011 Census that classified working activities in ten groups. Each occupational group was compared with a reference category represented by all other occupations, and rate ratio were calculated. Additive interaction between activity at work and age at ALS onset/sex on ALS incidence was calculated. RESULTS Employment in agriculture/breeding and in the armed forces were significantly associated with increasing ALS risk. None of the other assessed occupation groups was associated with change in the risk of ALS. Geographic analysis indicated that the effect of agriculture/breeding was particularly evident in the areas of higher risk for the general population. By contrast, an inverse pattern of spatial risk was associated with armed forces activity at work. The increased risk of ALS associated to agriculture/breeding was more evident in older people. No significant interaction was detected between working in the armed forces and older age/sex. CONCLUSIONS The significant interaction between agriculture/breeding and age suggests that the mechanisms leading to ALS are complex and involve several factors.
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Affiliation(s)
- Vincenzo Pierri
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Giuseppe Borghero
- Institute of Neurology, University Hospital of Cagliari, Cagliari, Italy
| | - Francesca Pili
- Institute of Neurology, University Hospital of Cagliari, Cagliari, Italy
| | - Tommaso Ercoli
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Luigi Isaia Lecca
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Rosario Vasta
- ALS Center, Rita Levi Montalcini Department of Neurosciences, University of Turin, Turin, Italy, and
| | - Marcello Campagna
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Adriano Chiò
- ALS Center, Rita Levi Montalcini Department of Neurosciences, University of Turin, Turin, Italy, and
| | - Giovanni Defazio
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Institute of Neurology, University Hospital of Cagliari, Cagliari, Italy
- Amyotrophic Lateral Sclerosis Center, University of Cagliari, Cagliari, Italy
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9
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Tiloca C, Goldwurm S, Calcagno N, Verde F, Peverelli S, Calini D, Zecchinelli AL, Sangalli D, Ratti A, Pezzoli G, Silani V, Ticozzi N. TARDBP mutations in a cohort of Italian patients with Parkinson’s disease and atypical parkinsonisms. Front Aging Neurosci 2022; 14:1020948. [PMID: 36247987 PMCID: PMC9557978 DOI: 10.3389/fnagi.2022.1020948] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 09/12/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundAggregates of TAR DNA-binding protein of 43 kDa (TDP-43) represent the pathological hallmark of most amyotrophic lateral sclerosis (ALS) and of nearly 50% of frontotemporal dementia (FTD) cases but were also observed to occur as secondary neuropathology in the nervous tissue of patients with different neurodegenerative diseases, including Parkinson’s disease (PD) and atypical parkinsonism. Mutations of TARDBP gene, mainly in exon 6 hotspot, have been reported to be causative of some forms of ALS and FTD, with clinical signs of parkinsonism observed in few mutation carriers.MethodsDirect DNA sequencing of TARDBP exon 6 was performed in a large Italian cohort of 735 patients affected by PD (354 familial and 381 sporadic) and 142 affected by atypical parkinsonism, including 39 corticobasal syndrome (CBS) and 103 progressive sopranuclear palsy (PSP). Sequencing data from 1710 healthy, ethnically matched controls were already available.ResultsFour TARDBP missense variants (p.N267S, p. G294A, p.G295S, p.S393L) were identified in four patients with typical PD and in two individuals with atypical parkinsonism (1 CBS and 1 PSP). None of the detected mutations were found in healthy controls and only the variant p.N267S was previously described in association to idiopathic familial and sporadic PD and to CBS.ConclusionIn this study we provide further insight into the clinical phenotypic heterogeneity associated with TARDBP mutations, which expands beyond the classical ALS and FTD diseases to include also PD and atypical parkinsonism, although with a low mutational frequency, varying considerably in different Caucasian populations. In addition, our study extends the spectrum of TARDBP pathogenetic mutations found in familial and sporadic PD.
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Affiliation(s)
- Cinzia Tiloca
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Stefano Goldwurm
- Parkinson Institute of Milan, ASST Gaetano Pini/CTO, Milan, Italy
| | - Narghes Calcagno
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Neurology Residency Program, Università degli Studi di Milano, 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
| | - Silvia Peverelli
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Daniela Calini
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | | | - Davide Sangalli
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Neurology – Stroke Unit, A. Manzoni Hospital – ASST Lecco, Lecco, Italy
| | - Antonia Ratti
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milan, Italy
| | - Gianni Pezzoli
- Parkinson Institute of Milan, ASST Gaetano Pini/CTO, 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
| | - 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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10
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Canosa A, Calvo A, Moglia C, Vasta R, Palumbo F, Fuda G, Di Pede F, Cabras S, Arena V, Novara A, Salamone P, Matteoni E, Sbaiz L, Gallone S, Grassano M, Manera U, Chiò A, Pagani M. Brain 18fluorodeoxyglucose-positron emission tomography changes in amyotrophic lateral sclerosis with TARDBP mutations. J Neurol Neurosurg Psychiatry 2022; 93:1021-1023. [PMID: 35351820 DOI: 10.1136/jnnp-2021-328296] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 01/14/2022] [Indexed: 11/04/2022]
Affiliation(s)
- Antonio Canosa
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin, Italy .,SC Neurologia 1U, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy.,Institute of Cognitive Sciences and Technologies, C.N.R, Rome, Italy
| | - Andrea Calvo
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin, Italy.,SC Neurologia 1U, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy.,Neuroscience Institute of Turin (NIT), Turin, Italy
| | - Cristina Moglia
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin, Italy.,SC Neurologia 1U, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Rosario Vasta
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin, Italy
| | - Francesca Palumbo
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin, Italy
| | - Giuseppe Fuda
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin, Italy
| | - Francesca Di Pede
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin, Italy
| | - Sara Cabras
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin, Italy
| | - Vincenzo Arena
- Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A, Turin, Italy
| | - Andrea Novara
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin, Italy
| | - Paolina Salamone
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin, Italy
| | - Enrico Matteoni
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin, Italy
| | - Luca Sbaiz
- Laboratory of Genetics, Department of Clinical Pathology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Salvatore Gallone
- SC Neurologia 1U, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Maurizio Grassano
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin, Italy
| | - Umberto Manera
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin, Italy.,SC Neurologia 1U, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Adriano Chiò
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin, Italy.,SC Neurologia 1U, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy.,Institute of Cognitive Sciences and Technologies, C.N.R, Rome, Italy.,Neuroscience Institute of Turin (NIT), Turin, Italy
| | - Marco Pagani
- Institute of Cognitive Sciences and Technologies, C.N.R, Rome, Italy.,Department of Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden
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11
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An Atypical Presentation of Upper Motor Neuron Predominant Juvenile Amyotrophic Lateral Sclerosis Associated with TARDBP Gene: A Case Report and Review of the Literature. Genes (Basel) 2022; 13:genes13081483. [PMID: 36011394 PMCID: PMC9407925 DOI: 10.3390/genes13081483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 08/11/2022] [Accepted: 08/15/2022] [Indexed: 11/17/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that can rarely affect young individuals. Juvenile ALS (JALS) is defined for individuals with an onset of the disease before the age of 25. The contribution of genetics to ALS pathology is a field of growing interest. One of the differences between adult-onset ALS and JALS is their genetic background, with a higher contribution of genetic causes in JALS. We report a patient with JALS and a pathogenic variant in the TARDBP gene (c.1035C > G; p.Asn345Lys), previously reported only in adult-onset ALS, and with an atypical phenotype of marked upper motor neuron predominance. In addition, the proband presented an additional variant in the NEK1 gene, c.2961C > G (p.Phe987Leu), which is classified as a variant of unknown significance. Segregation studies showed a paternal origin of the TARDBP variant, while the variant in NEK1 was inherited from the mother. We hypothesize that the NEK1 variant acts as a disease modifier and suggests the possibility of a functional interaction between both genes in our case. This hypothesis could explain the peculiarities of the phenotype, penetrance, and the age of onset. This report highlights the heterogeneity of the phenotypic presentation of ALS associated with diverse pathogenic genetic variants.
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12
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Xu F, Huang S, Li XY, Lin J, Feng X, Xie S, Wang Z, Li X, Zhu J, Lai H, Xu Y, Huang X, Yao X, Wang C. Identification of TARDBP Gly298Ser as a founder mutation for amyotrophic lateral sclerosis in Southern China. BMC Med Genomics 2022; 15:173. [PMID: 35932023 PMCID: PMC9356425 DOI: 10.1186/s12920-022-01327-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 07/30/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease characterized by predominant impairment of upper and lower motor neurons. Over 50 TARDBP mutations have been reported in both familial (FALS) and sporadic ALS (SALS). Some mutations in TARDBP, e.g. A382T and G294V, have genetic founder effects in certain geographic regions. However, such prevalence and founder effect have not been reported in Chinese. METHODS Whole-exome sequencing (WES) was performed in 16 Chinese FALS patients, followed by Sanger sequencing for the TARDBP p.Gly298Ser mutation (G298S) in 798 SALS patients and 1,325 controls. Haplotype analysis using microsatellites flanking TARDBP was conducted in the G298S-carrying patients and noncarriers. The geographic distribution and phenotypic correlation of the TARDBP mutations reported worldwide were reviewed. RESULTS WES detected the TARDBP G298S mutation in 8 FALS patients, and Sanger sequencing found additional 8 SALS cases, but no controls, carrying this mutation. All the 16 cases came from Southern China, and 7 of these patients shared the 117-286-257-145-246-270 allele for the D1S2736-D1S1151-D1S2667-D1S489-D1S434-D1S2697 markers, which was not found in the 92 non-carrier patients (0/92) (p < 0.0001) and 65 age-matched and neurologically normal individuals (0/65) (p < 0.0001). The A382T and G298S mutations were prevalent in Europeans and Eastern Asians, respectively. Additionally, carriers for the M337V mutation are dominated by bulbar onset with a long survival, whereas those for G298S are dominated by limb onset with a short survival. CONCLUSIONS Some prevalent TARDBP mutations are distributed in a geographic pattern and related to clinical profiles. TARDBP G298S mutation is a founder mutation in the Southern Chinese ALS population.
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Affiliation(s)
- Fanxi Xu
- Department of Neurology, National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital of Capital Medical University, No.45 Changchun Street, Beijing, 100053, China
| | - Sen Huang
- Department of Neurology, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Xu-Ying Li
- Department of Neurology, National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital of Capital Medical University, No.45 Changchun Street, Beijing, 100053, China.,Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China
| | - Jianing Lin
- Department of Neurology, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Xiuli Feng
- National Human Genome Center in Beijing, Beijing, China
| | - Shu Xie
- National Human Genome Center in Beijing, Beijing, China
| | - Zhanjun Wang
- Department of Neurology, National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital of Capital Medical University, No.45 Changchun Street, Beijing, 100053, China
| | - Xian Li
- Department of Neurology, National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital of Capital Medical University, No.45 Changchun Street, Beijing, 100053, China
| | - Junge Zhu
- Department of Neurology, National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital of Capital Medical University, No.45 Changchun Street, Beijing, 100053, China
| | - Hong Lai
- Department of Neurology, National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital of Capital Medical University, No.45 Changchun Street, Beijing, 100053, China
| | - Yanming Xu
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, China
| | - Xusheng Huang
- Department of Neurology of the First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Xiaoli Yao
- Department of Neurology, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China.
| | - Chaodong Wang
- Department of Neurology, National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital of Capital Medical University, No.45 Changchun Street, Beijing, 100053, China.
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13
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Muroni A, Floris G, Polizzi L, Fadda L, Piga G, Primicerio G, Rocchi L, Defazio G. Does epilepsy contribute to the clinical phenotype of C9orf72 mutation in fronto-temporal dementia? Epilepsy Behav 2022; 133:108783. [PMID: 35752055 DOI: 10.1016/j.yebeh.2022.108783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 05/17/2022] [Accepted: 05/30/2022] [Indexed: 11/25/2022]
Abstract
C9orf72 mutation is the most common genetic cause of frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS) worldwide. Recently, several reports of patients with FTD who carried the C9orf72 mutation and also manifested epilepsy have been published, since seizures occur in FTD at a higher rate than in the general population, the possible association between epilepsy and C9orf72 mutation remains to be clarified. In the attempt to understand whether epilepsy contributes to the phenotype of the C9orf72 mutation, we compared epilepsy occurrence in patients with FTD who carried the C9orf72 mutation and those who did not. In our sample of 84 patients with FTD, 7.1% of cases reported epilepsy, with no significant differences between subsamples of patients with FTD stratified according to the presence of the C9orf72 mutation or to family history of FTD/parkinsonism/motor neuron disease. Our findings did not support to the possibility that epilepsy represents a characteristic feature of the C9orf72 mutation, as suggested by recent case reports published in the English literature.
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Affiliation(s)
- Antonella Muroni
- Institute of Neurology, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy.
| | - Gianluca Floris
- Institute of Neurology, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy
| | - Lorenzo Polizzi
- Institute of Neurology, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy
| | - Laura Fadda
- Institute of Neurology, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy
| | - Giuseppe Piga
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Giulia Primicerio
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Lorenzo Rocchi
- Institute of Neurology, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy; Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Giovanni Defazio
- Institute of Neurology, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy; Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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14
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Su WM, Gu XJ, Duan QQ, Jiang Z, Gao X, Shang HF, Chen YP. Genetic factors for survival in amyotrophic lateral sclerosis: an integrated approach combining a systematic review, pairwise and network meta-analysis. BMC Med 2022; 20:209. [PMID: 35754054 PMCID: PMC9235235 DOI: 10.1186/s12916-022-02411-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/18/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The time of survival in patients with amyotrophic lateral sclerosis (ALS) varies greatly, and the genetic factors that contribute to the survival of ALS are not well studied. There is a lack of a comprehensive study to elucidate the role of genetic factors in the survival of ALS. METHODS The published studies were systematically searched and obtained from PubMed, EMBASE, and the Cochrane Library without any language restrictions from inception to Oct 27, 2021. A network meta-analysis for ALS causative/risk genes and a systematic review and pairwise meta-analysis for other genetic modifiers were conducted. The PROSPERO registration number: CRD42022311646. RESULTS A total of 29,764 potentially relevant references were identified, and 71 papers were eligible for analysis based on pre-decided criteria, including 35 articles in network meta-analysis for 9 ALS causative/risk genes, 17 articles in pairwise meta-analysis for four genetic modifiers, and 19 articles described in the systematic review. Variants in three genes, including ATXN2 (HR: 3.6), C9orf72 (HR: 1.6), and FUS (HR:1.8), were associated with short survival of ALS, but such association was not identified in SOD1, TARDBP, TBK1, NEK1, UBQLN2, and CCNF. In addition, UNC13A rs12608932 CC genotype and ZNF521B rs2275294 C allele also caused a shorter survival of ALS; however, APOE ε4 allele and KIFAP3 rs1541160 did not be found to have any effect on the survival of ALS. CONCLUSIONS Our study summarized and contrasted evidence for prognostic genetic factors in ALS and would help to understand ALS pathogenesis and guide clinical trials and drug development.
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Affiliation(s)
- Wei-Ming Su
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.,Lab of Neurodegenerative Disorders, Institute of Inflammation and Immunology (III), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.,Centre for Rare Diseases, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Xiao-Jing Gu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.,Lab of Neurodegenerative Disorders, Institute of Inflammation and Immunology (III), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.,Centre for Rare Diseases, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Qing-Qing Duan
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.,Lab of Neurodegenerative Disorders, Institute of Inflammation and Immunology (III), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.,Centre for Rare Diseases, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Zheng Jiang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.,Lab of Neurodegenerative Disorders, Institute of Inflammation and Immunology (III), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.,Centre for Rare Diseases, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Xia Gao
- Department of Geriatrics, Dazhou Central Hospital, Dazhou, Sichuan, China
| | - Hui-Fang Shang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.,Lab of Neurodegenerative Disorders, Institute of Inflammation and Immunology (III), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.,Centre for Rare Diseases, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yong-Ping Chen
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China. .,Lab of Neurodegenerative Disorders, Institute of Inflammation and Immunology (III), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China. .,Centre for Rare Diseases, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
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15
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Laaksovirta H, Launes J, Jansson L, Traynor BJ, Kaivola K, Tienari PJ. ALS in Finland. Neurol Genet 2022; 8:e665. [PMID: 35295181 PMCID: PMC8922337 DOI: 10.1212/nxg.0000000000000665] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 01/26/2022] [Indexed: 11/15/2022]
Abstract
Background and Objectives To analyze the frequencies of major genetic variants and the clinical features in Finnish patients with amyotrophic lateral sclerosis (ALS) with or without the C9orf72 hexanucleotide repeat expansion. Methods A cohort of patients with motor neuron disease was recruited between 1993 and 2020 at the Helsinki University Hospital and 2 second-degree outpatient clinics in Helsinki. Finnish ancestry patients with ALS fulfilled the diagnosis according to the revised El Escorial criteria and the Awaji-criteria. Two categories of familial ALS (FALS) were used. A patient was defined FALS-A if at least 1 first- or second-degree family member had ALS, and FALS-NP, if family members had additional neurologic or psychiatric endophenotypes. Results Of the 815 patients, 25% had FALS-A and 45% FALS-NP. C9orf72 expansion (C9pos) was found in 256 (31%) of all patients, in 58% of FALS-A category, in 48% of FALS-NP category, and in 23 or 17% of sporadic cases using the FALS-A or FALS-NP definition. C9pos or SOD1 p.D91A homozygosity was found in 328 (40%) of the 815 patients. We compared demographic and clinical characteristics between C9pos and patients with unknown cause of ALS (Unk). We found that the age at onset was significantly earlier and survival markedly shorter in the C9pos vs Unk patients with ALS. The shortest survival was found in bulbar-onset male C9pos patients, whereas the longest survival was found in Unk limb-onset males. Older age at onset associated consistently with shorter survival in C9pos and Unk patients in both limb-onset and bulbar-onset groups. There were no significant differences in the frequencies of bulbar-onset and limb-onset patients in C9pos and Unk groups. ALS-frontotemporal dementia (FTD) was more common in C9pos (17%) than in Unk (4%) patients, and of all patients with ALS-FTD, 70% were C9pos. Discussion These results provide further evidence for the short survival of C9orf72-associated ALS. A prominent role of the C9orf72 and SOD1 variants was found in the Finnish population. An unusually high frequency of C9pos was also found among patients with sporadic ALS. The enrichment of these 2 variants likely contributes to the high incidence of ALS in Finland.
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16
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Borghero G, Pierri V, Vasta R, Ercoli T, Primicerio G, Pili F, Gigante AF, Rocchi L, Chiò A, Defazio G. Incidence of amyotrophic lateral sclerosis in Sardinia, Italy: age-sex interaction and spatial-temporal variability. Amyotroph Lateral Scler Frontotemporal Degener 2022; 23:585-591. [PMID: 35188026 DOI: 10.1080/21678421.2022.2041670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Objective: This study assessed amyotrophic lateral sclerosis (ALS) incidence in Sardinia, Italy, and the combined contribution of age and gender to disease risk. We also checked disease incidence for spatial-temporal variability. Methods: ALS patients from all neurological centers of the study area who had onset during 2010-2019 and fulfilled El Escorial revised diagnostic criteria were included. Incidence was calculated for the overall study area and each province separately. Additive interaction between age and sex on ALS incidence was assessed. Results: The average crude annual incidence rate was 3.6/100,000 person-years (95% CI, 3.2-4.1), 3.1/100,000 person-years (95% CI, 2.7-3.5) when age-adjusted. Incidence was greater among people aged ≥65 years and men, with the two variables undergoing significant additive interaction. Incidence increased yearly over the study period, with annual incidence correlating with the increasing yearly frequency of people aged ≥65 years, but not with the proportion of incident cases carrying genetic mutations. Stratifying by province, the rates from Oristano and South Sardinia were higher than the rate from Cagliari. ALS patients from areas at different risk were comparable for frequency of clinical/genetic features. Conclusion: ALS incidence in Sardinia was in the upper part of the European range of variability. We also provided new information about age and sex as risk factors for ALS, showing male sex as a modifier of the effect of aging on ALS incidence. Spatial-temporal variations in ALS incidence correlated to changes in the proportion of the aging population rather than to the distribution of genetic factors.
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Affiliation(s)
- Giuseppe Borghero
- Institute of Neurology, University Hospital of Cagliari, Cagliari, Italy
| | - Vincenzo Pierri
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Rosario Vasta
- Rita Levi Montalcini Department of Neurosciences, ALS Center, University of Turin, Turin, Italy
| | - Tommaso Ercoli
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Giulia Primicerio
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Francesca Pili
- Institute of Neurology, University Hospital of Cagliari, Cagliari, Italy
| | | | - Lorenzo Rocchi
- Institute of Neurology, University Hospital of Cagliari, Cagliari, Italy.,Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Adriano Chiò
- Rita Levi Montalcini Department of Neurosciences, ALS Center, University of Turin, Turin, Italy
| | - Giovanni Defazio
- Institute of Neurology, University Hospital of Cagliari, Cagliari, Italy.,Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Amyotrophic Lateral Sclerosis Center, University of Cagliari, Cagliari, Italy
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17
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Giacomelli E, Vahsen BF, Calder EL, Xu Y, Scaber J, Gray E, Dafinca R, Talbot K, Studer L. Human stem cell models of neurodegeneration: From basic science of amyotrophic lateral sclerosis to clinical translation. Cell Stem Cell 2022; 29:11-35. [PMID: 34995492 PMCID: PMC8785905 DOI: 10.1016/j.stem.2021.12.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Neurodegenerative diseases are characterized by progressive cell loss leading to disruption of the structure and function of the central nervous system. Amyotrophic lateral sclerosis (ALS) was among the first of these disorders modeled in patient-specific iPSCs, and recent findings have translated into some of the earliest iPSC-inspired clinical trials. Focusing on ALS as an example, we evaluate the status of modeling neurodegenerative diseases using iPSCs, including methods for deriving and using disease-relevant neuronal and glial lineages. We further highlight the remaining challenges in exploiting the full potential of iPSC technology for understanding and potentially treating neurodegenerative diseases such as ALS.
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Affiliation(s)
- Elisa Giacomelli
- The Center for Stem Cell Biology, Developmental Biology Program, Sloan Kettering Institute for Cancer Research, New York, NY, USA
| | - Björn F Vahsen
- Oxford Motor Neuron Disease Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Elizabeth L Calder
- The Center for Stem Cell Biology, Developmental Biology Program, Sloan Kettering Institute for Cancer Research, New York, NY, USA
| | - Yinyan Xu
- Oxford Motor Neuron Disease Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK; Chinese Academy of Medical Sciences (CAMS), CAMS Oxford Institute (COI), Nuffield Department of Medicine, University of Oxford, Oxford OX3 7FZ, UK
| | - Jakub Scaber
- Oxford Motor Neuron Disease Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Elizabeth Gray
- Oxford Motor Neuron Disease Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Ruxandra Dafinca
- Oxford Motor Neuron Disease Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Kevin Talbot
- Oxford Motor Neuron Disease Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK.
| | - Lorenz Studer
- The Center for Stem Cell Biology, Developmental Biology Program, Sloan Kettering Institute for Cancer Research, New York, NY, USA.
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18
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Genetic architecture of motor neuron diseases. J Neurol Sci 2021; 434:120099. [PMID: 34965490 DOI: 10.1016/j.jns.2021.120099] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/26/2021] [Accepted: 12/14/2021] [Indexed: 12/18/2022]
Abstract
Motor neuron diseases (MNDs) are rare and frequently fatal neurological disorders in which motor neurons within the brainstem and spinal cord regions slowly die. MNDs are primarily caused by genetic mutations, and > 100 different mutant genes in humans have been discovered thus far. Given the fact that many more MND-related genes have yet to be discovered, the growing body of genetic evidence has offered new insights into the diverse cellular and molecular mechanisms involved in the aetiology and pathogenesis of MNDs. This search may aid in the selection of potential candidate genes for future investigation and, eventually, may open the door to novel interventions to slow down disease progression. In this review paper, we have summarized detailed existing research findings of different MNDs, such as amyotrophic lateral sclerosis (ALS), spinal muscular atrophy (SMA), spinal bulbar muscle atrophy (SBMA) and hereditary spastic paraplegia (HSP) in relation to their complex genetic architecture.
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19
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Melis M, Defazio G, Casaglia E, Melas V, Floris G. Early juvenile reading epilepsy and later frontotemporal dementia (FTD): expanding the clinical phenotype of C9ORF72 mutation? Amyotroph Lateral Scler Frontotemporal Degener 2021; 23:139-142. [PMID: 33818195 DOI: 10.1080/21678421.2021.1903505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
C9orf72 mutation (C9+) is a common genetic cause of frontotemporal dementia and amyotrophic lateral sclerosis. C9+ clinical phenotype is heterogeneous and epilepsy has been recently described in few cases. We report a 47-year-old patient who developed reflex reading epilepsy (RRE) at the age of 19. After the first years with exclusive reflex seizures, afterwards the patients developed drug-resistant, unprovoked seizures and progressive cognitive deterioration. In the last years, a progressive motor impairment with spastic tetraparesis also occurred. During the hospitalization, the patient underwent an extensive workup identifying C9+ expansion and a family history suggestive for an autosomal dominant inheritance. This report, together with the few cases already described, raises the possibility that epileptic manifestations are part of the clinical phenotype of C9ORF72 mutation and reflect hyperexcitability of cortical networks involved in neurodegeneration.
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Affiliation(s)
- Marta Melis
- SC Neurologia AOU Policlinico di Monserrato, Cagliari, Italy and
| | - Giovanni Defazio
- SC Neurologia AOU Policlinico di Monserrato, Cagliari, Italy and.,Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Elisa Casaglia
- SC Neurologia AOU Policlinico di Monserrato, Cagliari, Italy and
| | - Valerio Melas
- SC Neurologia AOU Policlinico di Monserrato, Cagliari, Italy and
| | - Gianluca Floris
- SC Neurologia AOU Policlinico di Monserrato, Cagliari, Italy and
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20
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Amyotrophic Lateral Sclerosis and Frontotemporal Lobar Degenerations: Similarities in Genetic Background. Diagnostics (Basel) 2021; 11:diagnostics11030509. [PMID: 33805659 PMCID: PMC7998502 DOI: 10.3390/diagnostics11030509] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/06/2021] [Accepted: 03/11/2021] [Indexed: 12/27/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a devastating, uniformly lethal progressive degenerative disorder of motor neurons that overlaps with frontotemporal lobar degeneration (FTLD) clinically, morphologically, and genetically. Although many distinct mutations in various genes are known to cause amyotrophic lateral sclerosis, it remains poorly understood how they selectively impact motor neuron biology and whether they converge on common pathways to cause neuronal degeneration. Many of the gene mutations are in proteins that share similar functions. They can be grouped into those associated with cell axon dynamics and those associated with cellular phagocytic machinery, namely protein aggregation and metabolism, apoptosis, and intracellular nucleic acid transport. Analysis of pathways implicated by mutant ALS genes has provided new insights into the pathogenesis of both familial forms of ALS (fALS) and sporadic forms (sALS), although, regrettably, this has not yet yielded definitive treatments. Many genes play an important role, with TARDBP, SQSTM1, VCP, FUS, TBK1, CHCHD10, and most importantly, C9orf72 being critical genetic players in these neurological disorders. In this mini-review, we will focus on the molecular mechanisms of these two diseases.
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21
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Glasmacher SA, Wong C, Pearson IE, Pal S. Survival and Prognostic Factors in C9orf72 Repeat Expansion Carriers: A Systematic Review and Meta-analysis. JAMA Neurol 2021; 77:367-376. [PMID: 31738367 DOI: 10.1001/jamaneurol.2019.3924] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Importance The c9orf72 repeat expansion (c9 or c9orf72RE) confers a survival disadvantage in amyotrophic lateral sclerosis (ALS); its effect on prognosis in frontotemporal dementia (FTD) remains uncertain. Data on prognostic factors in c9orf72RE disorders could inform patient care, genetic counseling, and trial design. Objective To examine prognostic factors in c9ALS, c9FTD, c9ALS-FTD, and atypical phenotypes. Data Sources The MEDLINE, Embase, Amed, ProQuest, PsychINFO, CINAHL, and LILACS databases were searched between January 2011 and January 2019. Keywords used were c9orf72 and chromosome 9 open reading frame 72. Reference lists, citations of eligible studies, and review articles were also searched by hand. Study Selection Studies reporting disease duration for patients with a confirmed c9orf72RE and a neurological and/or psychiatric disorder were included. A second author independently reviewed studies classified as irrelevant by the first author. Analysis began in January 2019. Data Extraction and Synthesis Data were extracted by 1 author; a further author independently extracted 10% of data. Data were synthesized in univariate and multivariable Cox regression and are displayed as hazard ratios (HR) and 95% confidence intervals. Main Outcomes and Measures Survival after symptom onset. Results Overall, 206 studies reporting on 1060 patients were included from 2878 publications identified (c9ALS: n = 455; c9FTD: n = 296; c9ALS-FTD: n = 198; atypical phenotypes: n = 111); 197 duplicate cases were excluded. The median (95% CI) survival (in years) differed significantly between patients with c9ALS (2.8 [2.67-3.00]), c9FTD (9.0 [8.09-9.91]), and c9ALS-FTD (3.0 [2.73-3.27]); survival in atypical phenotypes varied substantially. Older age at onset was associated with shorter survival in c9ALS (HR, 1.03; 95% CI, 1.02-1.04; P < .001), c9FTD (HR, 1.04; 95% CI, 1.02-1.06; P < .001), and c9ALS-FTD (HR, 1.02; 95% CI, 1.004-1.04; P = .016). Bulbar onset was associated with shorter survival in c9ALS (HR, 1.64; 95% CI, 1.27-2.08; P < .001). Age at onset and bulbar onset ALS remained significant in multivariable regression including variables indicating potential diagnostic ascertainment bias, selection bias, and reporting bias. Family history, sex, study continent, FTD subtype, or the presence of additional pathogenic sequence variants were not significantly associated with survival. Clinical phenotypes in patients with neuropathologically confirmed frontotemporal lobar degeneration-TDP-43, motor neuron disease-TDP-43 and frontotemporal lobar degeneration-motor neuron disease-TDP-43 were heterogenous and impacted on survival. Conclusions and Relevance Several factors associated with survival in c9orf72RE disorders were identified. The inherent limitations of our methodological approach must be considered; nonetheless, the reported prognostic factors were not significantly associated with the bias indicators examined.
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Affiliation(s)
- Stella A Glasmacher
- College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Charis Wong
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom.,Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh, United Kingdom.,Euan MacDonald Centre for Motor Neurone Disease Research, University of Edinburgh, Edinburgh, United Kingdom
| | - Iona E Pearson
- College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Suvankar Pal
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom.,Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh, United Kingdom.,Euan MacDonald Centre for Motor Neurone Disease Research, University of Edinburgh, Edinburgh, United Kingdom
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22
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Borg R, Farrugia Wismayer M, Bonavia K, Farrugia Wismayer A, Vella M, van Vugt JJFA, Kenna BJ, Kenna KP, Vassallo N, Veldink JH, Cauchi RJ. Genetic analysis of ALS cases in the isolated island population of Malta. Eur J Hum Genet 2021; 29:604-614. [PMID: 33414559 PMCID: PMC8115635 DOI: 10.1038/s41431-020-00767-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 10/16/2020] [Accepted: 10/23/2020] [Indexed: 12/11/2022] Open
Abstract
Genetic isolates are compelling tools for mapping genes of inherited disorders. The archipelago of Malta, a sovereign microstate in the south of Europe is home to a geographically and culturally isolated population. Here, we investigate the epidemiology and genetic profile of Maltese patients with amyotrophic lateral sclerosis (ALS), identified throughout a 2-year window. Cases were largely male (66.7%) with a predominant spinal onset of symptoms (70.8%). Disease onset occurred around mid-age (median age: 64 years, men; 59.5 years, female); 12.5% had familial ALS (fALS). Annual incidence rate was 2.48 (95% CI 1.59–3.68) per 100,000 person-years. Male-to-female incidence ratio was 1.93:1. Prevalence was 3.44 (95% CI 2.01–5.52) cases per 100,000 inhabitants on 31st December 2018. Whole-genome sequencing allowed us to determine rare DNA variants that change the protein-coding sequence of ALS-associated genes. Interestingly, the Maltese ALS patient cohort was found to be negative for deleterious variants in C9orf72, SOD1, TARDBP or FUS genes, which are the most commonly mutated ALS genes globally. Nonetheless, ALS-associated repeat expansions were identified in ATXN2 and NIPA1. Variants predicted to be damaging were also detected in ALS2, DAO, DCTN1, ERBB4, SETX, SCFD1 and SPG11. A total of 40% of patients with sporadic ALS had a rare and deleterious variant or repeat expansion in an ALS-associated gene, whilst the genetic cause of two thirds of fALS cases could not be pinpointed to known ALS genes or risk loci. This warrants further studies to elucidate novel genes that cause ALS in this unique population isolate.
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Affiliation(s)
- Rebecca Borg
- Centre for Molecular Medicine and Biobanking, Biomedical Sciences Building, University of Malta, Msida, Malta.,Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Maia Farrugia Wismayer
- Centre for Molecular Medicine and Biobanking, Biomedical Sciences Building, University of Malta, Msida, Malta.,Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Karl Bonavia
- Centre for Molecular Medicine and Biobanking, Biomedical Sciences Building, University of Malta, Msida, Malta
| | - Andrew Farrugia Wismayer
- Centre for Molecular Medicine and Biobanking, Biomedical Sciences Building, University of Malta, Msida, Malta
| | - Malcolm Vella
- Department of Neuroscience, Mater Dei Hospital, Msida, Malta
| | - Joke J F A van Vugt
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Brendan J Kenna
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Kevin P Kenna
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Neville Vassallo
- Centre for Molecular Medicine and Biobanking, Biomedical Sciences Building, University of Malta, Msida, Malta.,Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Jan H Veldink
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Ruben J Cauchi
- Centre for Molecular Medicine and Biobanking, Biomedical Sciences Building, University of Malta, Msida, Malta. .,Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.
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23
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Watkins J, Ghosh A, Keerie AFA, Alix JJP, Mead RJ, Sreedharan J. Female sex mitigates motor and behavioural phenotypes in TDP-43 Q331K knock-in mice. Sci Rep 2020; 10:19220. [PMID: 33154447 PMCID: PMC7645778 DOI: 10.1038/s41598-020-76070-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 10/20/2020] [Indexed: 12/12/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) are overlapping neurodegenerative disorders. ALS is more commonly seen in men than women and the same may be the case for FTD. Preclinical models demonstrating sex-specific vulnerability may help to understand female resistance to ALS-FTD and thereby identify routes to therapy. We previously characterised a TDP-43Q331K knock-in mouse, which demonstrated behavioural phenotypes reminiscent of ALS-FTD in males. Here we present our behavioural observations of female TDP-43Q331K mutants. Female TDP-43Q331K knock-in mice displayed increased weight relative to wild-type and increased food intake at 20 months of age, much later than previously observed in male mutants. Spontaneous digging behaviour was initially normal and only declined in mutants in the second year of life. Gait analysis using Catwalk (https://www.noldus.com/catwalk-xt) found significant deficits in the second year of life, while nocturnal running behaviour was attenuated from ~ 250 days of life. These results indicate that while female TDP-43Q331K knock-in mice do display progressive behavioural phenotypes, these are less severe than we previously noted in male mutants. Further studies of male and female TDP-43Q331K knock-in mice may help to unravel the mechanisms underlying sex-specific vulnerability in ALS-FTD.
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Affiliation(s)
- Jodie Watkins
- Department of Neuroscience, School of Medicine, Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, S10 2HQ, UK
| | - Anshua Ghosh
- Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Road, London, SE5 9RX, UK
| | - Amy F A Keerie
- Department of Neuroscience, School of Medicine, Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, S10 2HQ, UK
| | - James J P Alix
- Department of Neuroscience, School of Medicine, Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, S10 2HQ, UK
| | - Richard J Mead
- Department of Neuroscience, School of Medicine, Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, S10 2HQ, UK.
| | - Jemeen Sreedharan
- Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Road, London, SE5 9RX, UK.
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24
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Suk TR, Rousseaux MWC. The role of TDP-43 mislocalization in amyotrophic lateral sclerosis. Mol Neurodegener 2020; 15:45. [PMID: 32799899 PMCID: PMC7429473 DOI: 10.1186/s13024-020-00397-1] [Citation(s) in RCA: 165] [Impact Index Per Article: 41.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 08/07/2020] [Indexed: 02/07/2023] Open
Abstract
Since its discovery as a primary component in cytoplasmic aggregates in post-mortem tissue of patients with Amyotrophic Lateral Sclerosis (ALS), TAR DNA Binding Protein 43 kDa (TDP-43) has remained a central focus to understand the disease. TDP-43 links both familial and sporadic forms of ALS as mutations are causative for disease and cytoplasmic aggregates are a hallmark of nearly all cases, regardless of TDP-43 mutational status. Research has focused on the formation and consequences of cytosolic protein aggregates as drivers of ALS pathology through both gain- and loss-of-function mechanisms. Not only does aggregation sequester the normal function of TDP-43, but these aggregates also actively block normal cellular processes inevitably leading to cellular demise in a short time span. Although there may be some benefit to therapeutically targeting TDP-43 aggregation, this step may be too late in disease development to have substantial therapeutic benefit. However, TDP-43 pathology appears to be tightly linked with its mislocalization from the nucleus to the cytoplasm, making it difficult to decouple the consequences of nuclear-to-cytoplasmic mislocalization from protein aggregation. Studies focusing on the effects of TDP-43 mislocalization have demonstrated both gain- and loss-of-function consequences including altered splicing regulation, over responsiveness to cellular stressors, increases in DNA damage, and transcriptome-wide changes. Additionally, mutations in TARDBP confer a baseline increase in cytoplasmic TDP-43 thus suggesting that small changes in the subcellular localization of TDP-43 could in fact drive early pathology. In this review, we bring forth the theme of protein mislocalization as a key mechanism underlying ALS, by highlighting the importance of maintaining subcellular proteostasis along with the gain- and loss-of-functional consequences when TDP-43 localization is dysregulated. Additional research, focusing on early events in TDP-43 pathogenesis (i.e. to the protein mislocalization stage) will provide insight into disease mechanisms, therapeutic targets, and novel biomarkers for ALS.
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Affiliation(s)
- Terry R. Suk
- University of Ottawa Brain and Mind Research Institute, Ottawa, Canada
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Canada
| | - Maxime W. C. Rousseaux
- University of Ottawa Brain and Mind Research Institute, Ottawa, Canada
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Canada
- Eric Poulin Center for Neuromuscular Diseases, Ottawa, Canada
- Ottawa Institute of Systems Biology, Ottawa, Canada
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25
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Targeted next-generation sequencing study in familial ALS-FTD Portuguese patients negative for C9orf72 HRE. J Neurol 2020; 267:3578-3592. [DOI: 10.1007/s00415-020-10042-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/25/2020] [Accepted: 06/30/2020] [Indexed: 12/18/2022]
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26
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A Systematic Review of Genotype-Phenotype Correlation across Cohorts Having Causal Mutations of Different Genes in ALS. J Pers Med 2020; 10:jpm10030058. [PMID: 32610599 PMCID: PMC7564886 DOI: 10.3390/jpm10030058] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 06/09/2020] [Accepted: 06/15/2020] [Indexed: 12/13/2022] Open
Abstract
Amyotrophic lateral sclerosis is a rare and fatal neurodegenerative disease characterised by progressive deterioration of upper and lower motor neurons that eventually culminates in severe muscle atrophy, respiratory failure and death. There is a concerning lack of understanding regarding the mechanisms that lead to the onset of ALS and as a result there are no reliable biomarkers that aid in the early detection of the disease nor is there an effective treatment. This review first considers the clinical phenotypes associated with ALS, and discusses the broad categorisation of ALS and ALS-mimic diseases into upper and lower motor neuron diseases, before focusing on the genetic aetiology of ALS and considering the potential relationship of mutations of different genes to variations in phenotype. For this purpose, a systematic review is conducted collating data from 107 original published clinical studies on monogenic forms of the disease, surveying the age and site of onset, disease duration and motor neuron involvement. The collected data highlight the complexity of the disease's genotype-phenotype relationship, and thus the need for a nuanced approach to the development of clinical assays and therapeutics.
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Rooney J, Murray D, Campion A, Moloney H, Tattersall R, Doherty M, Hammond M, Heverin M, McLaughlin R, Hardiman O. The C9orf72 expansion is associated with accelerated respiratory function decline in a large Amyotrophic Lateral Sclerosis cohort. HRB Open Res 2019; 2:23. [PMID: 32296747 PMCID: PMC7140774 DOI: 10.12688/hrbopenres.12940.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2019] [Indexed: 12/11/2022] Open
Abstract
Introduction: The C9orf72 hexanucleotide repeat expansion is causal in amyotrophic lateral sclerosis (ALS) and has a negative effect on prognosis. The C9orf72 repeat expansion has been associated with an accelerated deterioration of respiratory function and survival in a cohort of 372 Portuguese patients. Methods: Cases presenting to the Irish ALS clinic with both longitudinal occluded sniff nasal inspiratory pressure (SNIP) and C9orf72 testing were including in the study. Clinical variables and survival characteristics of these patients were collected. Joint longitudinal and time to event models were constructed to explore the longitudinal characteristics of the cohort by C9orf72 status. Results: In total, 630 cases were included, of which 58 (9.2%) carried the C9orf72 repeat expansion. Plots of the longitudinal trend after joint modelling revealed that those carrying the expansion had worse respiratory function throughout the course of their disease than those without. The ALS Functional Rating Scale-revised (ALSFRS-R) respiratory sub-score did not distinguish C9orf72 normal from expanded cases. Furthermore, modelling by site of onset and gender sub-groups revealed that this difference was greatest in male spinal onset cases. Joint models further indicated that occluded SNIP values were of prognostic importance. Conclusions: Our results confirm findings from Portugal that the C9orf72 repeat expansion is associated with accelerated respiratory function decline. Analysis via joint models indicate that respiratory function is of prognostic importance and may explain previous observations of poorer prognosis in male spinal onset patients carrying the C9orf72 expansion.
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Affiliation(s)
- James Rooney
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Deirdre Murray
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland.,Beaumont Hospital, Dublin, Ireland
| | | | - Hannah Moloney
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | | | - Mark Doherty
- Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - Michaela Hammond
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Mark Heverin
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | | | - Orla Hardiman
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland.,Beaumont Hospital, Dublin, Ireland
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Goldstein O, Kedmi M, Gana-Weisz M, Twito S, Nefussy B, Vainer B, Fainmesser Y, Abraham A, Nayshool O, Orr-Urtreger A, Drory VE. Rare homozygosity in amyotrophic lateral sclerosis suggests the contribution of recessive variants to disease genetics. J Neurol Sci 2019; 402:62-68. [DOI: 10.1016/j.jns.2019.05.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 05/02/2019] [Accepted: 05/07/2019] [Indexed: 02/06/2023]
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29
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Mutant TDP-43 Causes Early-Stage Dose-Dependent Motor Neuron Degeneration in a TARDBP Knockin Mouse Model of ALS. Cell Rep 2019; 26:364-373.e4. [DOI: 10.1016/j.celrep.2018.12.045] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 08/16/2018] [Accepted: 12/11/2018] [Indexed: 12/12/2022] Open
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Newell K, Paron F, Mompean M, Murrell J, Salis E, Stuani C, Pattee G, Romano M, Laurents D, Ghetti B, Buratti E. Dysregulation of TDP-43 intracellular localization and early onset ALS are associated with a TARDBP S375G variant. Brain Pathol 2018; 29:397-413. [PMID: 30461104 PMCID: PMC6875182 DOI: 10.1111/bpa.12680] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 11/12/2018] [Indexed: 02/06/2023] Open
Abstract
We investigated the Central Nervous System (CNS) and skeletal muscle tissue from A woman was clinically diagnosed with amyotrophic lateral sclerosis (ALS) at the age of 22. Neuropathologic evaluation showed upper and lower motor neuron loss, corticospinal tract degeneration and skeletal muscle denervation. Analysis of the patient's Deoxyribonucleic acid (DNA) revealed a AGT>GGT change resulting in an S375G substitution in the C-terminal region of TDP-43. This variant was previously reported as being benign. Considering the early onset and severity of the disease in this patient, we tested the effects of this genetic variant on TDP-43 localization, pre-mRNA splicing activity and toxicity, in parallel with the effects on known neighboring disease-associated mutations. In cell lines, expressed in culture, S375G TDP-43 appeared to be more significantly localized in the nucleus and to exert higher toxicity than wild-type TDP-43. Strikingly, a phosphomimic mutant at the same residue (S375E) showed a strong tendency to accumulate in the cytoplasm, especially under stress conditions, and molecular dynamics simulations suggest that phosphorylation of this residue can disrupt TDP-43 intermolecular interactions. The results of the current study highlight the importance of phosphorylation and regulation of TDP-43 nuclear-cytoplasmic shuttling/redistribution, in relation to the pathogenetic mechanisms involved in different forms of ALS.
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Affiliation(s)
- Kathy Newell
- University of Kansas School of Medicine, Pathology & Laboratory Medicine, Kansas City, MO
| | - Francesca Paron
- International Centre for Genetic Engineering and Biotechnology (ICGEB), Trieste, Italy
| | - Miguel Mompean
- University of Castile-La Mancha, Instituto Regional de Investigación Científica Aplicada (IRICA), Ciudad Real, Spain
| | - Jill Murrell
- Indiana University School of Medicine, Pathology & Laboratory Medicine, Indianapolis, IN
| | - Elisa Salis
- International Centre for Genetic Engineering and Biotechnology (ICGEB), Trieste, Italy
| | - Cristiana Stuani
- International Centre for Genetic Engineering and Biotechnology (ICGEB), Trieste, Italy
| | - Gary Pattee
- University of Nebraska Medical Center, Lincoln, NE
| | - Maurizio Romano
- Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Douglas Laurents
- Instituto de Química Física "Rocasolano", Consejo Superior de Investigaciones Científicas, Madrid, Spain
| | - Bernardino Ghetti
- Indiana University School of Medicine, Pathology & Laboratory Medicine, Indianapolis, IN
| | - Emanuele Buratti
- International Centre for Genetic Engineering and Biotechnology (ICGEB), Trieste, Italy
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31
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Masala A, Sanna S, Esposito S, Rassu M, Galioto M, Zinellu A, Carru C, Carrì MT, Iaccarino C, Crosio C. Epigenetic Changes Associated with the Expression of Amyotrophic Lateral Sclerosis (ALS) Causing Genes. Neuroscience 2018; 390:1-11. [DOI: 10.1016/j.neuroscience.2018.08.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 07/11/2018] [Accepted: 08/07/2018] [Indexed: 12/13/2022]
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32
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Xu GR, Hu W, Zhan LL, Wang C, Xu LQ, Lin MT, Chen WJ, Wang N, Zhang QJ. High frequency of the TARDBP p.M337 V mutation among south-eastern Chinese patients with familial amyotrophic lateral sclerosis. BMC Neurol 2018; 18:35. [PMID: 29621978 PMCID: PMC5887188 DOI: 10.1186/s12883-018-1028-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 02/28/2018] [Indexed: 01/06/2023] Open
Abstract
Background Amyotrophic lateral sclerosis (ALS) is a devastating motor neuron disease characterized by substantial clinical and genetic heterogeneity. Thus far, only a few TARDBP-ALS families have been reported in China, and no mutation analysis has been reported in south-eastern China. Methods Seven index cases from ALS families negative for SOD1 and FUS mutations were screened by Sanger sequencing for TARDBP gene exons 2-6. TARDBP exon 6 was analysed in 215 sporadic ALS patients. Results Two TARDBP mutations in exon 6 (p.M337 V and p.G348C) were identified in 5 unrelated families. Four of these 5 families carried the same p.M337 V mutation (family 1II3, family 2II6, family 3II4, and family 4II4), and the p.G348C mutation was identified in family 5 (II5). Among the 215 sporadic patients, only a single nucleotide polymorphism (p.A366A) was detected in 5 patients, and no responsible mutation was identified. Among the TARDBP-linked familial ALS patients, the average age of onset was 57.0 ± 4.7 years, and a trend towards higher rates of bulbar (50.0%, 6/12) onset and upper limb (41.7%, 5/12) onset than lower rates of limb onset (8.3%, 1/12) was observed. Furthermore, ALS patients with TARDBP mutations showed a benign disease course, and the average survival was 106.5 ± 41.8 months (n = 8). Conclusions We found a high frequency of the TARDBP p.M337 V mutation in familial ALS in south-eastern China. The TARDBP-linked ALS patients showed a benign disease course and prolonged survival. Electronic supplementary material The online version of this article (10.1186/s12883-018-1028-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Guo-Rong Xu
- Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, China
| | - Wei Hu
- Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, China
| | - Ling-Ling Zhan
- Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, China
| | - Chong Wang
- Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, China
| | - Liu-Qing Xu
- Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, China
| | - Min-Ting Lin
- Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, China
| | - Wan-Jin Chen
- Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, China.,Fujian Key Laboratory of Molecular Neurology, Fuzhou, China
| | - Ning Wang
- Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, China. .,Fujian Key Laboratory of Molecular Neurology, Fuzhou, China.
| | - Qi-Jie Zhang
- Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, China. .,Fujian Key Laboratory of Molecular Neurology, Fuzhou, China.
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33
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White MA, Kim E, Duffy A, Adalbert R, Phillips BU, Peters OM, Stephenson J, Yang S, Massenzio F, Lin Z, Andrews S, Segonds-Pichon A, Metterville J, Saksida LM, Mead R, Ribchester RR, Barhomi Y, Serre T, Coleman MP, Fallon JR, Bussey TJ, Brown RH, Sreedharan J. TDP-43 gains function due to perturbed autoregulation in a Tardbp knock-in mouse model of ALS-FTD. Nat Neurosci 2018; 21:552-563. [PMID: 29556029 PMCID: PMC5884423 DOI: 10.1038/s41593-018-0113-5] [Citation(s) in RCA: 158] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 01/15/2018] [Indexed: 12/12/2022]
Abstract
Amyotrophic lateral sclerosis-frontotemporal dementia (ALS-FTD) constitutes a devastating disease spectrum characterized by 43-kDa TAR DNA-binding protein (TDP-43) pathology. Understanding how TDP-43 contributes to neurodegeneration will help direct therapeutic efforts. Here we have created a TDP-43 knock-in mouse with a human-equivalent mutation in the endogenous mouse Tardbp gene. TDP-43Q331K mice demonstrate cognitive dysfunction and a paucity of parvalbumin interneurons. Critically, TDP-43 autoregulation is perturbed, leading to a gain of TDP-43 function and altered splicing of Mapt, another pivotal dementia-associated gene. Furthermore, a new approach to stratify transcriptomic data by phenotype in differentially affected mutant mice revealed 471 changes linked with improved behavior. These changes included downregulation of two known modifiers of neurodegeneration, Atxn2 and Arid4a, and upregulation of myelination and translation genes. With one base change in murine Tardbp, this study identifies TDP-43 misregulation as a pathogenic mechanism that may underpin ALS-FTD and exploits phenotypic heterogeneity to yield candidate suppressors of neurodegenerative disease.
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Affiliation(s)
- Matthew A White
- The Babraham Institute, Cambridge, UK
- Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Eosu Kim
- Department of Psychology and MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
- Department of Psychiatry, Institute of Behavioral Science in Medicine, Brain Korea 21 Plus Project for Medical Sciences, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Amanda Duffy
- Department of Neuroscience, Brown University, Providence, RI, USA
| | - Robert Adalbert
- John van Geest Centre for Brain Repair, University of Cambridge, Cambridge, UK
| | - Benjamin U Phillips
- Department of Psychology and MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Owen M Peters
- The Vollum Institute, Oregon Health & Science University, Portland, OR, USA
- School of Biosciences, Dementia Research Institute, Cardiff University, Cardiff, UK
| | - Jodie Stephenson
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK
- Centre for Neuroscience and Trauma, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Sujeong Yang
- John van Geest Centre for Brain Repair, University of Cambridge, Cambridge, UK
| | - Francesca Massenzio
- The Babraham Institute, Cambridge, UK
- Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ziqiang Lin
- The Babraham Institute, Cambridge, UK
- Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | | | - Jake Metterville
- Department of Neurology, UMass Medical School, Worcester, MA, USA
| | - Lisa M Saksida
- Department of Psychology and MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
- Molecular Medicine Research Group, Robarts Research Institute & Department of Physiology and Pharmacology, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- The Brain and Mind Institute, Western University, London, ON, Canada
| | - Richard Mead
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK
| | | | - Youssef Barhomi
- Department of Cognitive, Linguistic and Psychological Sciences, Brown University, Providence, RI, USA
| | - Thomas Serre
- Department of Cognitive, Linguistic and Psychological Sciences, Brown University, Providence, RI, USA
| | - Michael P Coleman
- The Babraham Institute, Cambridge, UK
- John van Geest Centre for Brain Repair, University of Cambridge, Cambridge, UK
| | - Justin R Fallon
- Department of Neuroscience, Brown University, Providence, RI, USA
| | - Timothy J Bussey
- Department of Psychology and MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
- Molecular Medicine Research Group, Robarts Research Institute & Department of Physiology and Pharmacology, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- The Brain and Mind Institute, Western University, London, ON, Canada
| | - Robert H Brown
- Department of Neurology, UMass Medical School, Worcester, MA, USA
| | - Jemeen Sreedharan
- The Babraham Institute, Cambridge, UK.
- Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
- Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
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34
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Nguyen HP, Van Broeckhoven C, van der Zee J. ALS Genes in the Genomic Era and their Implications for FTD. Trends Genet 2018; 34:404-423. [PMID: 29605155 DOI: 10.1016/j.tig.2018.03.001] [Citation(s) in RCA: 204] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 10/04/2017] [Accepted: 03/02/2018] [Indexed: 12/12/2022]
Abstract
Amyotrophic lateral sclerosis (ALS) is a complex neurodegenerative disease, characterized genetically by a disproportionately large contribution of rare genetic variation. Driven by advances in massive parallel sequencing and applied on large patient-control cohorts, systematic identification of these rare variants that make up the genetic architecture of ALS became feasible. In this review paper, we present a comprehensive overview of recently proposed ALS genes that were identified based on rare genetic variants (TBK1, CHCHD10, TUBA4A, CCNF, MATR3, NEK1, C21orf2, ANXA11, TIA1) and their potential relevance to frontotemporal dementia genetic etiology. As more causal and risk genes are identified, it has become apparent that affected individuals can carry multiple disease-associated variants. In light of this observation, we discuss the oligogenic architecture of ALS. To end, we highlight emerging key molecular processes and opportunities for therapy.
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Affiliation(s)
- Hung Phuoc Nguyen
- Neurodegenerative Brain Diseases Group, Center for Molecular Neurology, VIB, Antwerp, Belgium; Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Christine Van Broeckhoven
- Neurodegenerative Brain Diseases Group, Center for Molecular Neurology, VIB, Antwerp, Belgium; Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Julie van der Zee
- Neurodegenerative Brain Diseases Group, Center for Molecular Neurology, VIB, Antwerp, Belgium; Institute Born-Bunge, University of Antwerp, Antwerp, Belgium.
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35
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High frequency of C9orf72 hexanucleotide repeat expansion in amyotrophic lateral sclerosis patients from two founder populations sharing the same risk haplotype. Neurobiol Aging 2017; 64:160.e1-160.e7. [PMID: 29352617 DOI: 10.1016/j.neurobiolaging.2017.12.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 12/17/2017] [Indexed: 01/07/2023]
Abstract
We characterized the C9orf72 hexanucleotide repeat expansion (RE) mutation in amyotrophic lateral sclerosis (ALS) patients of 2 distinct origins, Ashkenazi and North Africa Jews (AJ, NAJ), its frequency, and genotype-phenotype correlations. In AJ, 80% of familial ALS (fALS) and 11% of sporadic ALS carried the RE, a total of 12.9% of all AJ-ALS compared to 0.3% in AJ controls (odds ratio [OR] = 44.3, p < 0.0001). In NAJ, 10% of fALS and 9% of sporadic ALS carried the RE, a total of 9.1% of all NAJ-ALS compared to 1% in controls (OR = 9.9, p = 0.0006). We identified a risk haplotype shared among all ALS patients, although an association with age at disease onset, fALS, and dementia were observed only in AJ. Variations were identified downstream the repeats. The risk haplotype and these polymorphisms were at high frequencies in alleles with 8 repeats or more, suggesting sequence instability. The different genotype-phenotype correlations and OR, together with the large range in age at onset, suggest that other modifiers and risk factors may affect penetrance and phenotype in ALS.
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Lugliè A, Giacobbe MG, Riccardi E, Bruno M, Pigozzi S, Mariani MA, Satta CT, Stacca D, Bazzoni AM, Caddeo T, Farina P, Padedda BM, Pulina S, Sechi N, Milandri A. Paralytic Shellfish Toxins and Cyanotoxins in the Mediterranean: New Data from Sardinia and Sicily (Italy). Microorganisms 2017; 5:microorganisms5040072. [PMID: 29144421 PMCID: PMC5748581 DOI: 10.3390/microorganisms5040072] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 11/12/2017] [Accepted: 11/13/2017] [Indexed: 12/14/2022] Open
Abstract
Harmful algal blooms represent a severe issue worldwide. They affect ecosystem functions and related services and goods, with consequences on human health and socio-economic activities. This study reports new data on paralytic shellfish toxins (PSTs) from Sardinia and Sicily (Italy), the largest Mediterranean islands where toxic events, mainly caused by Alexandrium species (Dinophyceae), have been ascertained in mussel farms since the 2000s. The toxicity of the A. minutum, A. tamarense and A. pacificum strains, established from the isolation of vegetative cells and resting cysts, was determined by high performance liquid chromatography (HPLC). The analyses indicated the highest toxicity for A. pacificum strains (total PSTs up to 17.811 fmol cell-1). The PSTs were also assessed in a strain of A. tamarense. The results encourage further investigation to increase the knowledge of toxic species still debated in the Mediterranean. This study also reports new data on microcystins (MCs) and β-N-methylamino-L-alanine (BMAA) from a Sardinian artificial lake (Lake Bidighinzu). The presence of MCs and BMAA was assessed in natural samples and in cell cultures by enzyme-linked immunosorbent assay (ELISA). BMAA positives were found in all the analysed samples with a maximum of 17.84 µg L-1. The obtained results added further information on cyanotoxins in Mediterranean reservoirs, particularly BMAA, which have not yet been thoroughly investigated.
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Affiliation(s)
- Antonella Lugliè
- Dipartimento di Architettura, Design e Urbanistica, University of Sassari, Via Piandanna 4, 07100 Sassari, Italy.
| | - Maria Grazia Giacobbe
- Istituto per l'Ambiente Marino Costiero, CNR, Spianata S. Raineri 86, 98122 Messina, Italy.
| | - Elena Riccardi
- Fondazione Centro Ricerche Marine, National Reference Laboratory for Marine Biotoxins, Viale A. Vespucci 2, 47042 Cesenatico (FC), Italy.
| | - Milena Bruno
- Environmental Quality and Fish Farming, Environment and Primary Prevention, Istituto Superiore di Sanità, V.le Regina Elena 299, 00161 Rome, Italy.
| | - Silvia Pigozzi
- Fondazione Centro Ricerche Marine, National Reference Laboratory for Marine Biotoxins, Viale A. Vespucci 2, 47042 Cesenatico (FC), Italy.
| | - Maria Antonietta Mariani
- Dipartimento di Architettura, Design e Urbanistica, University of Sassari, Via Piandanna 4, 07100 Sassari, Italy.
| | - Cecilia Teodora Satta
- Dipartimento di Architettura, Design e Urbanistica, University of Sassari, Via Piandanna 4, 07100 Sassari, Italy.
- Agenzia Regionale per la Ricerca in Agricoltura (AGRIS), Servizio Ittico, S.S. Sassari-Fertilia Km 18,600, Bonassai, 07040 Olmedo, Italy.
| | - Daniela Stacca
- Dipartimento di Architettura, Design e Urbanistica, University of Sassari, Via Piandanna 4, 07100 Sassari, Italy.
| | - Anna Maria Bazzoni
- Dipartimento di Ispezione degli Alimenti, Istituto Zooprofilattico Sperimentale della Sardegna G. Pegreffi, Via Duca degli Abruzzi 8, 07100 Sassari, Italy.
| | - Tiziana Caddeo
- Dipartimento di Architettura, Design e Urbanistica, University of Sassari, Via Piandanna 4, 07100 Sassari, Italy.
| | - Pasqualina Farina
- Dipartimento di Architettura, Design e Urbanistica, University of Sassari, Via Piandanna 4, 07100 Sassari, Italy.
| | - Bachisio Mario Padedda
- Dipartimento di Architettura, Design e Urbanistica, University of Sassari, Via Piandanna 4, 07100 Sassari, Italy.
| | - Silvia Pulina
- Dipartimento di Architettura, Design e Urbanistica, University of Sassari, Via Piandanna 4, 07100 Sassari, Italy.
- Department of Life and Environmental Sciences, University of Cagliari, Via Fiorelli 1, 09126 Cagliari, Italy.
| | - Nicola Sechi
- Dipartimento di Architettura, Design e Urbanistica, University of Sassari, Via Piandanna 4, 07100 Sassari, Italy.
| | - Anna Milandri
- Fondazione Centro Ricerche Marine, National Reference Laboratory for Marine Biotoxins, Viale A. Vespucci 2, 47042 Cesenatico (FC), Italy.
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Piaceri I, Bessi V, Matà S, Polito C, Tedde A, Berti V, Bagnoli S, Braccia A, Del Mastio M, Pignone AM, Pupi A, Sorbi S, Nacmias B. Association of the New Variant Tyr424Asp at TBK1 Gene with Amyotrophic Lateral Sclerosis and Cognitive Decline. J Alzheimers Dis 2017; 61:41-46. [PMID: 29103041 DOI: 10.3233/jad-170694] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
A new risk gene associated with amyotrophic lateral sclerosis (ALS) has recently been identified: the Tank-binding kinase 1 (TBK1) gene. Up to now, 90 TBK1 variants have been described in ALS patients with or without frontotemporal dementia (FTD), thus making TBK1 the third or fourth most frequent genetic cause of ALS and FTD. A point mutation analysis in a cohort of 69 Italian ALS patients was performed in order to analyze the frequency of TBK1 mutations and the correlation with clinical phenotypes. The analysis identified the novel variant p.Tyr424Asp in a patient with a rapid progression of the disease. Our data supports the implication of TBK1 in ALS pathogenesis in Italy.
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Affiliation(s)
- Irene Piaceri
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Valentina Bessi
- Neurology Unit of Careggi University Hospital, Florence, Italy
| | - Sabrina Matà
- Neurology Unit of Careggi University Hospital, Florence, Italy
| | - Cristina Polito
- Department of Biomedical, Experimental and Clinical Sciences, "Mario Serio", Nuclear Medicine Unit, University of Florence, Florence, Italy
| | - Andrea Tedde
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Valentina Berti
- Department of Biomedical, Experimental and Clinical Sciences, "Mario Serio", Nuclear Medicine Unit, University of Florence, Florence, Italy
| | - Silvia Bagnoli
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Arianna Braccia
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | | | | | - Alberto Pupi
- Department of Biomedical, Experimental and Clinical Sciences, "Mario Serio", Nuclear Medicine Unit, University of Florence, Florence, Italy
| | - Sandro Sorbi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy.,Neurology Unit of Careggi University Hospital, Florence, Italy.,IRCCS Don Gnocchi, Florence, Italy
| | - Benedetta Nacmias
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
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Zou ZY, Zhou ZR, Che CH, Liu CY, He RL, Huang HP. Genetic epidemiology of amyotrophic lateral sclerosis: a systematic review and meta-analysis. J Neurol Neurosurg Psychiatry 2017; 88:540-549. [PMID: 28057713 DOI: 10.1136/jnnp-2016-315018] [Citation(s) in RCA: 319] [Impact Index Per Article: 45.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 11/04/2016] [Accepted: 12/13/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND Genetic studies have shown that C9orf72, SOD1, TARDBP and FUS are the most common mutated genes in amyotrophic lateral sclerosis (ALS). Here, we performed a meta-analysis to determine the mutation frequencies of these major ALS-related genes in patients with ALS. METHODS We performed an extensive literature research to identify all original articles reporting frequencies of C9orf72, SOD1, TARDBP and FUS mutations in ALS. The mutation frequency and effect size of each study were combined. Possible sources of heterogeneity across studies were determined by meta-regression, sensitivity analysis and subgroup analysis. RESULTS 111 studies were included in the meta-analysis. The overall pooled mutation frequencies of these major ALS-related genes were 47.7% in familial amyotrophic lateral sclerosis (FALS) and 5.2% in sporadic ALS (SALS). A significant difference was identified regarding the frequencies of mutations in major ALS genes between European and Asian patients. In European populations, the most common mutations were the C9orf72 repeat expansions (FALS 33.7%, SALS 5.1%), followed by SOD1 (FALS 14.8%, SALS 1.2%), TARDBP (FALS 4.2%, SALS 0.8%) and FUS mutations (FALS 2.8%, SALS 0.3%), while in Asian populations the most common mutations were SOD1 mutations (FALS 30.0%, SALS 1.5%), followed by FUS (FALS 6.4%, SALS 0.9%), C9orf72 (FALS 2.3%, SALS 0.3%) and TARDBP (FALS 1.5%, SALS 0.2%) mutations. CONCLUSIONS These findings demonstrated that the genetic architecture of ALS in Asian populations is distinct from that in European populations, which need to be given appropriate consideration when performing genetic testing of patients with ALS.
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Affiliation(s)
- Zhang-Yu Zou
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Zhi-Rui Zhou
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Chun-Hui Che
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Chang-Yun Liu
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Rao-Li He
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Hua-Pin Huang
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China
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39
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Hardiman O, Al-Chalabi A, Brayne C, Beghi E, van den Berg LH, Chio A, Martin S, Logroscino G, Rooney J. The changing picture of amyotrophic lateral sclerosis: lessons from European registers. J Neurol Neurosurg Psychiatry 2017; 88:557-563. [PMID: 28285264 DOI: 10.1136/jnnp-2016-314495] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 01/24/2017] [Accepted: 01/24/2017] [Indexed: 12/12/2022]
Abstract
Prospective population based-registers of amyotrophic lateral sclerosis (ALS) have operated in Europe for over two decades, and have provided important insights into our understanding of ALS. Here, we review the benefits that population registers have brought to the understanding of the incidence, prevalence, phenotype and genetics of ALS and outline the core operating principles that underlie these registers and facilitate international collaboration. Going forward, we offer lessons learned from our collective experience of operating population-based ALS registers in Europe for over two decades, focusing on register design, maintenance, identification and management of bias and the value of cross-national harmonisation and integration.
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Affiliation(s)
- Orla Hardiman
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College, Dublin, Ireland.,Department of Neurology, Beaumont Hospital, Beaumont, Ireland
| | - Ammar Al-Chalabi
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Carol Brayne
- Cambridge Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Ettore Beghi
- Neurological Diseases Laboratory, Department of Neurosciences, IRCCS Mario Negri, Milano, Italy
| | - Leonard H van den Berg
- Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Adriano Chio
- Department of Neurosciences, University of Turin, Turin, Italy
| | - Sarah Martin
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - James Rooney
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College, Dublin, Ireland
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40
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Garton FC, Benyamin B, Zhao Q, Liu Z, Gratten J, Henders AK, Zhang ZH, Edson J, Furlong S, Morgan S, Heggie S, Thorpe K, Pfluger C, Mather KA, Sachdev PS, McRae AF, Robinson MR, Shah S, Visscher PM, Mangelsdorf M, Henderson RD, Wray NR, McCombe PA. Whole exome sequencing and DNA methylation analysis in a clinical amyotrophic lateral sclerosis cohort. Mol Genet Genomic Med 2017; 5:418-428. [PMID: 28717666 PMCID: PMC5511806 DOI: 10.1002/mgg3.302] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 04/28/2017] [Accepted: 05/04/2017] [Indexed: 02/06/2023] Open
Abstract
Background Gene discovery has provided remarkable biological insights into amyotrophic lateral sclerosis (ALS). One challenge for clinical application of genetic testing is critical evaluation of the significance of reported variants. Methods We use whole exome sequencing (WES) to develop a clinically relevant approach to identify a subset of ALS patients harboring likely pathogenic mutations. In parallel, we assess if DNA methylation can be used to screen for pathogenicity of novel variants since a methylation signature has been shown to associate with the pathogenic C9orf72 expansion, but has not been explored for other ALS mutations. Australian patients identified with ALS‐relevant variants were cross‐checked with population databases and case reports to critically assess whether they were “likely causal,” “uncertain significance,” or “unlikely causal.” Results Published ALS variants were identified in >10% of patients; however, in only 3% of patients (4/120) could these be confidently considered pathogenic (in SOD1 and TARDBP). We found no evidence for a differential DNA methylation signature in these mutation carriers. Conclusions The use of WES in a typical ALS clinic demonstrates a critical approach to variant assessment with the capability to combine cohorts to enhance the largely unknown genetic basis of ALS.
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Affiliation(s)
- Fleur C Garton
- Queensland Brain InstituteThe University of QueenslandSt LuciaQueensland4072Australia.,Institute for Molecular BioscienceThe University of QueenslandSt LuciaQueensland4072Australia
| | - Beben Benyamin
- Queensland Brain InstituteThe University of QueenslandSt LuciaQueensland4072Australia.,Institute for Molecular BioscienceThe University of QueenslandSt LuciaQueensland4072Australia
| | - Qiongyi Zhao
- Queensland Brain InstituteThe University of QueenslandSt LuciaQueensland4072Australia
| | - Zhijun Liu
- Queensland Brain InstituteThe University of QueenslandSt LuciaQueensland4072Australia.,Institute for Molecular BioscienceThe University of QueenslandSt LuciaQueensland4072Australia
| | - Jacob Gratten
- Queensland Brain InstituteThe University of QueenslandSt LuciaQueensland4072Australia.,Institute for Molecular BioscienceThe University of QueenslandSt LuciaQueensland4072Australia
| | - Anjali K Henders
- Queensland Brain InstituteThe University of QueenslandSt LuciaQueensland4072Australia.,Institute for Molecular BioscienceThe University of QueenslandSt LuciaQueensland4072Australia
| | - Zong-Hong Zhang
- Queensland Brain InstituteThe University of QueenslandSt LuciaQueensland4072Australia
| | - Janette Edson
- Queensland Brain InstituteThe University of QueenslandSt LuciaQueensland4072Australia
| | - Sarah Furlong
- Queensland Brain InstituteThe University of QueenslandSt LuciaQueensland4072Australia
| | - Sarah Morgan
- Reta Lila Weston InstituteUCL Institute of NeurologyLondonUK.,Department of Molecular NeuroscienceUCL Institute of NeurologyLondonUK
| | - Susan Heggie
- UQ Centre for Clinical ResearchThe University of QueenslandRoyal Brisbane & Women's HospitalBrisbane4029Australia
| | - Kathryn Thorpe
- UQ Centre for Clinical ResearchThe University of QueenslandRoyal Brisbane & Women's HospitalBrisbane4029Australia
| | - Casey Pfluger
- UQ Centre for Clinical ResearchThe University of QueenslandRoyal Brisbane & Women's HospitalBrisbane4029Australia
| | - Karen A Mather
- Centre for Healthy Brain AgeingSchool of PsychiatryFaculty of MedicineThe University of New South WalesSydneyNew South Wales2052Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain AgeingSchool of PsychiatryFaculty of MedicineThe University of New South WalesSydneyNew South Wales2052Australia.,Neuropsychiatric InstitutePrince of Wales HospitalRandwickNew South WalesAustralia
| | - Allan F McRae
- Queensland Brain InstituteThe University of QueenslandSt LuciaQueensland4072Australia.,Institute for Molecular BioscienceThe University of QueenslandSt LuciaQueensland4072Australia
| | - Matthew R Robinson
- Queensland Brain InstituteThe University of QueenslandSt LuciaQueensland4072Australia.,Institute for Molecular BioscienceThe University of QueenslandSt LuciaQueensland4072Australia
| | - Sonia Shah
- Queensland Brain InstituteThe University of QueenslandSt LuciaQueensland4072Australia
| | - Peter M Visscher
- Queensland Brain InstituteThe University of QueenslandSt LuciaQueensland4072Australia.,Institute for Molecular BioscienceThe University of QueenslandSt LuciaQueensland4072Australia.,University of Queensland Diamantina InstituteTranslational Research InstituteBrisbaneQueensland4012Australia
| | - Marie Mangelsdorf
- Queensland Brain InstituteThe University of QueenslandSt LuciaQueensland4072Australia
| | - Robert D Henderson
- Department of NeurologyRoyal Brisbane & Women's HospitalBrisbane4029Australia
| | - Naomi R Wray
- Queensland Brain InstituteThe University of QueenslandSt LuciaQueensland4072Australia.,Institute for Molecular BioscienceThe University of QueenslandSt LuciaQueensland4072Australia
| | - Pamela A McCombe
- UQ Centre for Clinical ResearchThe University of QueenslandRoyal Brisbane & Women's HospitalBrisbane4029Australia
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Forte G, Bocca B, Oggiano R, Clemente S, Asara Y, Sotgiu MA, Farace C, Montella A, Fois AG, Malaguarnera M, Pirina P, Madeddu R. Essential trace elements in amyotrophic lateral sclerosis (ALS): Results in a population of a risk area of Italy. Neurol Sci 2017; 38:1609-1615. [DOI: 10.1007/s10072-017-3018-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 06/02/2017] [Indexed: 12/12/2022]
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42
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Rooney J, Fogh I, Westeneng HJ, Vajda A, McLaughlin R, Heverin M, Jones A, van Eijk R, Calvo A, Mazzini L, Shaw C, Morrison K, Shaw PJ, Robberecht W, Van Damme P, Al-Chalabi A, van den Berg L, Chiò A, Veldink J, Hardiman O. C9orf72 expansion differentially affects males with spinal onset amyotrophic lateral sclerosis. J Neurol Neurosurg Psychiatry 2017; 88:281. [PMID: 27663272 DOI: 10.1136/jnnp-2016-314093] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 08/19/2016] [Accepted: 08/30/2016] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The C9orf72 repeat expansion has been reported as a negative prognostic factor in amyotrophic lateral sclerosis (ALS). We have examined the prognostic impact of the C9orf72 repeat expansion in European subgroups based on gender and site of onset. METHODS C9orf72 status and demographic/clinical data from 4925 patients with ALS drawn from 3 prospective ALS registers (Ireland, Italy and the Netherlands), and clinical data sets in the UK and Belgium. Flexible parametric survival models were built including known prognostic factors (age, diagnostic delay and site of onset), gender and the presence of an expanded repeat in C9orf72. These were used to explore the effects of C9orf72 on survival by gender and site of onset. Individual patient data (IPD) meta-analysis was used to estimate HRs for results of particular importance. RESULTS 457 (8.95%) of 4925 ALS cases carried the C9orf72 repeat expansion. A meta-analysis of C9orf72 estimated a survival HR of 1.36 (1.18 to 1.57) for those carrying the expansion. Models evaluating interaction between gender and C9orf72 repeat expansions demonstrated that the reduced survival due to C9orf72 expansion was being driven by spinal onset males (HR 1.56 (95% CI 1.25 to 1.96). CONCLUSIONS This study represents the largest combined analysis of the prognostic characteristics of the C9orf72 expansion. We have shown for the first time that the negative prognostic implication of this variant is driven by males with spinal onset disease, indicating a hitherto unrecognised gender-mediated effect of the variant that requires further exploration.
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Affiliation(s)
- James Rooney
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College, Dublin, Ireland
| | - Isabella Fogh
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Henk-Jan Westeneng
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Alice Vajda
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College, Dublin, Ireland
| | - Russell McLaughlin
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College, Dublin, Ireland
| | - Mark Heverin
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College, Dublin, Ireland
| | - Ashley Jones
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ruben van Eijk
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Andrea Calvo
- Department of Neuroscience, ALS Centre, University of Torino, Turin, Italy
| | - Letizia Mazzini
- Department of Neurology, ALS Center, Azienda Ospedaliera Universitaria Maggiore Della Carità, Novara, Italy
| | - Christopher Shaw
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Karen Morrison
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Pamela J Shaw
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK
| | - Wim Robberecht
- Department of Neurosciences, Experimental Neurology-Laboratory of Neurobiology, KU Leuven-University of Leuven, Belgium.,Vlaams Instituut voor Biotechnologie (VIB), Vesalius Research Center, Laboratory of Neurobiology, Leuven, Belgium
| | - Phillip Van Damme
- Department of Neurosciences, Experimental Neurology-Laboratory of Neurobiology, KU Leuven-University of Leuven, Belgium.,Department of Neurology, University Hospital Leuven, Leuven, Belgium
| | - Ammar Al-Chalabi
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Leonard van den Berg
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Adriano Chiò
- Department of Neuroscience, ALS Centre, University of Torino, Turin, Italy
| | - Jan Veldink
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Orla Hardiman
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College, Dublin, Ireland.,Department of Neurology, Beaumont Hospital, Dublin, Ireland
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Vajda A, McLaughlin RL, Heverin M, Thorpe O, Abrahams S, Al-Chalabi A, Hardiman O. Genetic testing in ALS: A survey of current practices. Neurology 2017; 88:991-999. [PMID: 28159885 PMCID: PMC5333513 DOI: 10.1212/wnl.0000000000003686] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 12/13/2016] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To determine the degree of consensus among clinicians on the clinical use of genetic testing in amyotrophic lateral sclerosis (ALS) and the factors that determine decision-making. METHODS ALS researchers worldwide were invited to participate in a detailed online survey to determine their attitudes and practices relating to genetic testing. RESULTS Responses from 167 clinicians from 21 different countries were analyzed. The majority of respondents (73.3%) do not consider that there is a consensus definition of familial ALS (FALS). Fifty-seven percent consider a family history of frontotemporal dementia and 48.5% the presence of a known ALS genetic mutation as sufficient for a diagnosis of FALS. Most respondents (90.2%) offer genetic testing to patients they define as having FALS and 49.4% to patients with sporadic ALS. Four main genes (SOD1, C9orf72, TARDBP, and FUS) are commonly tested. A total of 55.2% of respondents would seek genetic testing if they had personally received a diagnosis of ALS. Forty-two percent never offer presymptomatic testing to family members of patients with FALS. Responses varied between ALS specialists and nonspecialists and based on the number of new patients seen per year. CONCLUSIONS There is a lack of consensus among clinicians as to the definition of FALS. Substantial variation exists in attitude and practices related to genetic testing of patients and presymptomatic testing of their relatives across geographic regions and between experienced specialists in ALS and nonspecialists.
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Affiliation(s)
- Alice Vajda
- From the Academic Unit of Neurology (A.V., R.L.M., M.H., O.T., O.H.), Trinity College Dublin; Cognitive Aging and Epidemiology Centre (S.A.), University of Edinburgh; and Institute of Psychiatry, Psychology and Neuroscience (A.A.-C.), King's College London, UK.
| | - Russell L McLaughlin
- From the Academic Unit of Neurology (A.V., R.L.M., M.H., O.T., O.H.), Trinity College Dublin; Cognitive Aging and Epidemiology Centre (S.A.), University of Edinburgh; and Institute of Psychiatry, Psychology and Neuroscience (A.A.-C.), King's College London, UK
| | - Mark Heverin
- From the Academic Unit of Neurology (A.V., R.L.M., M.H., O.T., O.H.), Trinity College Dublin; Cognitive Aging and Epidemiology Centre (S.A.), University of Edinburgh; and Institute of Psychiatry, Psychology and Neuroscience (A.A.-C.), King's College London, UK
| | - Owen Thorpe
- From the Academic Unit of Neurology (A.V., R.L.M., M.H., O.T., O.H.), Trinity College Dublin; Cognitive Aging and Epidemiology Centre (S.A.), University of Edinburgh; and Institute of Psychiatry, Psychology and Neuroscience (A.A.-C.), King's College London, UK
| | - Sharon Abrahams
- From the Academic Unit of Neurology (A.V., R.L.M., M.H., O.T., O.H.), Trinity College Dublin; Cognitive Aging and Epidemiology Centre (S.A.), University of Edinburgh; and Institute of Psychiatry, Psychology and Neuroscience (A.A.-C.), King's College London, UK
| | - Ammar Al-Chalabi
- From the Academic Unit of Neurology (A.V., R.L.M., M.H., O.T., O.H.), Trinity College Dublin; Cognitive Aging and Epidemiology Centre (S.A.), University of Edinburgh; and Institute of Psychiatry, Psychology and Neuroscience (A.A.-C.), King's College London, UK
| | - Orla Hardiman
- From the Academic Unit of Neurology (A.V., R.L.M., M.H., O.T., O.H.), Trinity College Dublin; Cognitive Aging and Epidemiology Centre (S.A.), University of Edinburgh; and Institute of Psychiatry, Psychology and Neuroscience (A.A.-C.), King's College London, UK
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Lucchesi C, Caldarazzo Ienco E, Fabbrini M, Pasquali L, Lo Gerfo A, Fogli A, Siciliano G. Amyotrophic lateral sclerosis with long lasting disease course and SOD1 and TARDBP mutations: Report of two cases and overview of the literature. Amyotroph Lateral Scler Frontotemporal Degener 2017; 18:137-139. [DOI: 10.1080/21678421.2016.1212896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Cinzia Lucchesi
- Department of Clinical and Experimental Medicine, Institute of Neurology, University of Pisa, Pisa, Italy and
| | - Elena Caldarazzo Ienco
- Department of Clinical and Experimental Medicine, Institute of Neurology, University of Pisa, Pisa, Italy and
| | - Monica Fabbrini
- Department of Clinical and Experimental Medicine, Institute of Neurology, University of Pisa, Pisa, Italy and
| | - Livia Pasquali
- Department of Clinical and Experimental Medicine, Institute of Neurology, University of Pisa, Pisa, Italy and
| | - Annalisa Lo Gerfo
- Department of Clinical and Experimental Medicine, Institute of Neurology, University of Pisa, Pisa, Italy and
| | - Antonella Fogli
- U.O. Laboratorio Genetica Medica, Santa Chiara Hospital, Pisa, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, Institute of Neurology, University of Pisa, Pisa, Italy and
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45
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Chadi G, Maximino JR, Jorge FMDH, Borba FCD, Gilio JM, Callegaro D, Lopes CG, Santos SND, Rebelo GNS. Genetic analysis of patients with familial and sporadic amyotrophic lateral sclerosis in a Brazilian Research Center. Amyotroph Lateral Scler Frontotemporal Degener 2016; 18:249-255. [DOI: 10.1080/21678421.2016.1254245] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Gerson Chadi
- Neuroregeneration Center, Department of Neurology, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Jessica Ruivo Maximino
- Neuroregeneration Center, Department of Neurology, University of São Paulo School of Medicine, São Paulo, Brazil
| | | | - Fabrício Castro de Borba
- Neuroregeneration Center, Department of Neurology, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Joyce Meire Gilio
- Neuroregeneration Center, Department of Neurology, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Dagoberto Callegaro
- Neuroregeneration Center, Department of Neurology, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Camila Galvão Lopes
- Neuroregeneration Center, Department of Neurology, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Samantha Nakamura Dos Santos
- Neuroregeneration Center, Department of Neurology, University of São Paulo School of Medicine, São Paulo, Brazil
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46
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Puligheddu M, Congiu P, Aricò D, Rundo F, Borghero G, Marrosu F, Fantini ML, Ferri R. Isolated rapid eye movement sleep without atonia in amyotrophic lateral sclerosis. Sleep Med 2016; 26:16-22. [PMID: 28007355 DOI: 10.1016/j.sleep.2016.05.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 05/14/2016] [Accepted: 05/20/2016] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The aim of this study was to quantitatively analyze, with the most recent and advanced tools, the presence of periodic leg movements during sleep (PLMS) and/or rapid eye movement (REM) sleep without atonia (RSWA), in a group of patients with amyotrophic lateral sclerosis (ALS), and to assess their eventual correlation with the clinical severity of the disease. METHODS Twenty-nine ALS patients were enrolled (mean age 63.6 years) along with 28 age-matched "normal" controls (mean age 63.8 years). Functional impairment due to ALS was evaluated using the ALS-Functional Rating Scale-Revised (ALS-FRS) and the ALS severity scale (ALSSS). Full video polysomnographic night recordings were obtained, and PLMS were analyzed by considering their number/hour of sleep and periodicity index, the distribution of intermovement intervals, and the distribution during the night. The characteristics of the chin electromyogram (EMG) amplitude during REM sleep were analyzed by means of the automatic atonia index and the number of chin EMG activations (movements). RESULTS The ALS patients showed longer sleep latency than the controls, together with an increase in number of stage shifts, increased sleep stage 1, and decreased sleep stage 2. None of the leg PLMS parameters were different between the ALS patients and controls. The REM atonia index was significantly decreased in the ALS patients, and the number of chin movements/hour tended to increase. Both REM atonia index and number of chin movements/hour correlated significantly with the ALS-FRS; REM atonia was higher and chin movements were less in ALS patients with more preserved function (higher scores on the ALS-FRS). CONCLUSION Abnormal REM sleep atonia seemed to be a genuine effect of ALS pathology per se and correlated with the clinical severity of the disease. It is unclear if this might constitute the basis of a possible risk for the development of REM sleep behavior disorder or represent a form of isolated RSWA in ALS.
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Affiliation(s)
- Monica Puligheddu
- Sleep Disorder Center, Department of Public Health, Clinical & Molecular Medicine, University of Cagliari, Monserrato, CA, Italy; UOC Neurology, University of Cagliari, Monserrato, CA, Italy.
| | - Patrizia Congiu
- Sleep Disorder Center, Department of Public Health, Clinical & Molecular Medicine, University of Cagliari, Monserrato, CA, Italy
| | - Debora Aricò
- Department of Neurology, Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS), Troina, Italy
| | - Francesco Rundo
- Department of Neurology, Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS), Troina, Italy
| | | | - Francesco Marrosu
- Sleep Disorder Center, Department of Public Health, Clinical & Molecular Medicine, University of Cagliari, Monserrato, CA, Italy; UOC Neurology, University of Cagliari, Monserrato, CA, Italy
| | - Maria Livia Fantini
- Neurology Service, CHU Clermont-Ferrand, UFR Medicine, Clermont-Ferrand, France
| | - Raffaele Ferri
- Department of Neurology, Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS), Troina, Italy
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Ishiura H, Tsuji S. Epidemiology and molecular mechanism of frontotemporal lobar degeneration/amyotrophic lateral sclerosis with repeat expansion mutation in C9orf72. J Neurogenet 2016; 29:85-94. [PMID: 26540641 DOI: 10.3109/01677063.2015.1085980] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
GGGGCC hexanucleotide repeat expansions in C9orf72 were identified in 2011 as the genetic cause of frontotemporal lobar degeneration (FTLD)/amyotrophic lateral sclerosis (ALS) linked to chromosome 9. Since then, a number of studies have been conducted to delineate the molecular epidemiology of the repeat expansions and the molecular pathophysiology of the disease. The frequency of the repeat expansions considerably varied among countries. The frequency of the repeat expansions was high in European populations and populations of European descent and a substantial proportion of sporadic FTLD or ALS patients also have the mutations in these populations. On the other hand, the frequency was extremely low in Asia or Oceania except for limited regions including Kii Peninsula of Japan. A founder effect seems to strongly influence the regional differences in the frequency, but there is no definitive evidence that supports the notion that the repeat expansions arose in a single founder or multiple founders. As a disease-causing mechanism, several molecular mechanisms have been proposed, including conformational changes of DNA (G-quadruplex formation and hypermethylation) or RNA (G-quadruplex formation) molecules, altered transcriptional levels of C9orf72, sequestration of RNA-binding proteins, bidirectional transcription, formation of RNA foci, and neurotoxicity of dipeptide repeat proteins generated by repeat-associated non-ATG-initiated translation. Further investigations on the molecular mechanisms of neurodegeneration are expected to lead to the development of therapeutic interventions for this disease as well as for other diseases associated with non-coding repeat expansions.
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Affiliation(s)
- Hiroyuki Ishiura
- a Department of Neurology , The University of Tokyo , Tokyo , Japan
| | - Shoji Tsuji
- a Department of Neurology , The University of Tokyo , Tokyo , Japan
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Umoh ME, Fournier C, Li Y, Polak M, Shaw L, Landers JE, Hu W, Gearing M, Glass JD. Comparative analysis of C9orf72 and sporadic disease in an ALS clinic population. Neurology 2016; 87:1024-30. [PMID: 27488601 DOI: 10.1212/wnl.0000000000003067] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 05/23/2016] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE We investigated whether the C9orf72 expansion mutation in patients with amyotrophic lateral sclerosis (ALS) is associated with unique demographic and clinical features. METHODS Between 2001 and 2015, approximately half of all patients attending the Emory ALS Clinic agreed to donate DNA for research. This research cohort of 781 patients was screened for the C9orf72 expansion, and demographic and clinical data were compared between those with and without the C9orf72 mutation. For mutation carriers without a family history of ALS, we sought further family history of dementia and other non-ALS neurodegenerative diseases in first-degree relatives. RESULTS The C9orf72 expansion was identified in 61 patients (7.8%). Compared to those without the expansion mutation, these patients did not differ in race, age, or site of onset. As expected, C9orf72 patients were more likely to have a family history of ALS (59% vs 7.9%) and to present with comorbid frontotemporal dementia (FTD) (14.8% vs 1.7%). Survival was shorter in patients with the expansion (log-rank χ(2)[1] = 45.323, p < 0.001). Further investigation in 28 patients initially categorized as having no known family history of ALS identified a family history of dementia in 16 cases; 6 of these had characteristics suggestive of FTD. CONCLUSIONS Comparing the C9orf72 ALS population to the general ALS population, there were no differences in race, age at onset, or proportion of patients with bulbar onset disease. Differences identified in patients with the C9orf72 mutation included shortened survival and an equal proportion of men and women. In addition, we found that assessing family history for dementia may identify other family members likely to be carrying the C9orf72 expansion, reduce the number of sporadic cases, and thus increase our understanding of disease penetrance.
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Affiliation(s)
- Mfon E Umoh
- From the Center for Neurodegenerative Disease (M.E.U., W.H., M.G., J.D.G.), Department of Neurology (M.E.U., C.F., Y.L., M.P., L.S., W.H., M.G., J.D.G.), and Pathology and Laboratory Medicine (M.G., J.D.G.), Emory University School of Medicine, Atlanta, GA; and the Department of Neurology (J.E.L.), University of Massachusetts Medical School, Worcester
| | - Christina Fournier
- From the Center for Neurodegenerative Disease (M.E.U., W.H., M.G., J.D.G.), Department of Neurology (M.E.U., C.F., Y.L., M.P., L.S., W.H., M.G., J.D.G.), and Pathology and Laboratory Medicine (M.G., J.D.G.), Emory University School of Medicine, Atlanta, GA; and the Department of Neurology (J.E.L.), University of Massachusetts Medical School, Worcester
| | - Yingjie Li
- From the Center for Neurodegenerative Disease (M.E.U., W.H., M.G., J.D.G.), Department of Neurology (M.E.U., C.F., Y.L., M.P., L.S., W.H., M.G., J.D.G.), and Pathology and Laboratory Medicine (M.G., J.D.G.), Emory University School of Medicine, Atlanta, GA; and the Department of Neurology (J.E.L.), University of Massachusetts Medical School, Worcester
| | - Meraida Polak
- From the Center for Neurodegenerative Disease (M.E.U., W.H., M.G., J.D.G.), Department of Neurology (M.E.U., C.F., Y.L., M.P., L.S., W.H., M.G., J.D.G.), and Pathology and Laboratory Medicine (M.G., J.D.G.), Emory University School of Medicine, Atlanta, GA; and the Department of Neurology (J.E.L.), University of Massachusetts Medical School, Worcester
| | - Latoya Shaw
- From the Center for Neurodegenerative Disease (M.E.U., W.H., M.G., J.D.G.), Department of Neurology (M.E.U., C.F., Y.L., M.P., L.S., W.H., M.G., J.D.G.), and Pathology and Laboratory Medicine (M.G., J.D.G.), Emory University School of Medicine, Atlanta, GA; and the Department of Neurology (J.E.L.), University of Massachusetts Medical School, Worcester
| | - John E Landers
- From the Center for Neurodegenerative Disease (M.E.U., W.H., M.G., J.D.G.), Department of Neurology (M.E.U., C.F., Y.L., M.P., L.S., W.H., M.G., J.D.G.), and Pathology and Laboratory Medicine (M.G., J.D.G.), Emory University School of Medicine, Atlanta, GA; and the Department of Neurology (J.E.L.), University of Massachusetts Medical School, Worcester
| | - William Hu
- From the Center for Neurodegenerative Disease (M.E.U., W.H., M.G., J.D.G.), Department of Neurology (M.E.U., C.F., Y.L., M.P., L.S., W.H., M.G., J.D.G.), and Pathology and Laboratory Medicine (M.G., J.D.G.), Emory University School of Medicine, Atlanta, GA; and the Department of Neurology (J.E.L.), University of Massachusetts Medical School, Worcester
| | - Marla Gearing
- From the Center for Neurodegenerative Disease (M.E.U., W.H., M.G., J.D.G.), Department of Neurology (M.E.U., C.F., Y.L., M.P., L.S., W.H., M.G., J.D.G.), and Pathology and Laboratory Medicine (M.G., J.D.G.), Emory University School of Medicine, Atlanta, GA; and the Department of Neurology (J.E.L.), University of Massachusetts Medical School, Worcester
| | - Jonathan D Glass
- From the Center for Neurodegenerative Disease (M.E.U., W.H., M.G., J.D.G.), Department of Neurology (M.E.U., C.F., Y.L., M.P., L.S., W.H., M.G., J.D.G.), and Pathology and Laboratory Medicine (M.G., J.D.G.), Emory University School of Medicine, Atlanta, GA; and the Department of Neurology (J.E.L.), University of Massachusetts Medical School, Worcester.
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The Association between C9orf72 Repeats and Risk of Alzheimer's Disease and Amyotrophic Lateral Sclerosis: A Meta-Analysis. PARKINSONS DISEASE 2016; 2016:5731734. [PMID: 27375918 PMCID: PMC4916312 DOI: 10.1155/2016/5731734] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 04/04/2016] [Indexed: 12/12/2022]
Abstract
C9orf72 is the most common genetic cause of amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) in Caucasian populations. However, the relationship between C9orf72 repeats and Alzheimer's disease (AD) was not clear. Additionally, there were few articles assessing C9orf72 in other ethnicities with ALS. In this meta-analysis, we aimed to investigate the relationship between C9orf72 repeat expansions (≥30 repeats) and intermediate repeat copies (20–29 repeats) and AD or ALS. The results suggested positive correlations between C9orf72 repeat expansions and the risk of Alzheimer's disease (OR = 6.36, 95% CI = 3.13–12.92, and p < 0.00001), while intermediate repeat copies of C9orf72 gene were not associated with the risk of the disease. C9orf72 repeat expansions were positively correlated with the risk of familial and sporadic ALS (OR = 293.25, 95% CI = 148.17–580.38, and p < 0.00001; OR = 35.57, 95% CI = 19.61–64.51, and p < 0.00001). There was a positive correlation between the gene variations and ALS risk among Caucasians and Asians (OR = 57.56, 95% CI = 36.73–90.22, and p < 0.00001; OR = 6.35, 95% CI = 1.39–29.02, and p = 0.02).
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Level of neurotoxic metals in amyotrophic lateral sclerosis: A population-based case–control study. J Neurol Sci 2015; 359:11-7. [DOI: 10.1016/j.jns.2015.10.023] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 09/18/2015] [Accepted: 10/12/2015] [Indexed: 12/13/2022]
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