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Lombardi M, Corrado L, Piola B, Comi C, Cantello R, D’Alfonso S, Mazzini L, De Marchi F. Variability in Clinical Phenotype in TARDBP Mutations: Amyotrophic Lateral Sclerosis Case Description and Literature Review. Genes (Basel) 2023; 14:2039. [PMID: 38002982 PMCID: PMC10671725 DOI: 10.3390/genes14112039] [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: 10/13/2023] [Revised: 10/30/2023] [Accepted: 10/31/2023] [Indexed: 11/26/2023] Open
Abstract
Mutations in the 43 kDa transactive-response (TAR)-DNA-binding protein (TARDBP) are associated with 2-5% of familial Amyotrophic Lateral Sclerosis (ALS) cases. TAR DNA-Binding Protein 43 (TDP-43) is an RNA/DNA-binding protein involved in several cellular mechanisms (e.g., transcription, pre-mRNA processing, and splicing). Many ALS-linked TARDBP mutations have been described in the literature, but few phenotypic data on monogenic TARDBP-mutated ALS are available. In this paper, (1) we describe the clinical features of ALS patients carrying mutations in the TARDBP gene evaluated at the Tertiary ALS Center at Maggiore della Carità University Hospital, Novara, Italy, from 2010 to 2020 and (2) present the results of our review of the literature on this topic, analyzing data obtained for 267 patients and highlighting their main clinical and demographic features.
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Affiliation(s)
- Michele Lombardi
- ALS Center, Neurology Unit, Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy; (M.L.); (R.C.); (L.M.)
| | - Lucia Corrado
- Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy; (L.C.); (B.P.); (S.D.)
| | - Beatrice Piola
- Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy; (L.C.); (B.P.); (S.D.)
| | - Cristoforo Comi
- Neurology Unit, S. Andrea Hospital, Department of Translational Medicine, University of Piemonte Orientale, 13100 Vercelli, Italy;
| | - Roberto Cantello
- ALS Center, Neurology Unit, Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy; (M.L.); (R.C.); (L.M.)
| | - Sandra D’Alfonso
- Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy; (L.C.); (B.P.); (S.D.)
| | - Letizia Mazzini
- ALS Center, Neurology Unit, Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy; (M.L.); (R.C.); (L.M.)
| | - Fabiola De Marchi
- ALS Center, Neurology Unit, Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy; (M.L.); (R.C.); (L.M.)
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Sung W, Kim JA, Kim YS, Park J, Oh KW, Sung JJ, Ki CS, Kim YE, Kim SH. An analysis of variants in TARDBP in the Korean population with amyotrophic lateral sclerosis: comparison with previous data. Sci Rep 2023; 13:18805. [PMID: 37914747 PMCID: PMC10620191 DOI: 10.1038/s41598-023-45593-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 10/21/2023] [Indexed: 11/03/2023] Open
Abstract
The TARDBP gene variant is a known major cause of amyotrophic lateral sclerosis (ALS), with limited reports of Korean patients with ALS harboring the variants in TARDBP. This large cohort study introduces four ALS patients who share the p.M337V variant of the TARDBP, allowing for an investigation of clinical characteristics and prognosis by analyzing previously reported cases with the same variant. From November 2014 to August 2022, participants were recruited from two tertiary hospitals in Seoul, Korea. Clinical characteristics of patients diagnosed with ALS carrying the variant in TARDBP were evaluated. Previous articles demonstrating subjects' characteristics were reviewed. Four patients were identified with the pathogenic missense variant (c.1009A>G; p.M337V) in the TARDBP. The mean age of onset was 55 years old, and none of the patients showed severe cognitive impairment. Sixty-three patients carrying the p.M337V variant in TARDBP from this study and previous reports delineated young age of onset (51.6 years), high frequency of bulbar onset patients (61.9%), and low comorbidity of frontotemporal dementia. This study reveals the presence of pathogenic variant of TARDBP in Korea and emphasizes the importance of genetic screening of the TARDBP gene, in diagnosing ALS and evaluating prognosis among familial and simplex ALS patients in Korea.
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Affiliation(s)
- Wonjae Sung
- Department of Neurology, College of Medicine, Hanyang University, Wangsimni-ro 222, Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Jin-Ah Kim
- Department of Translational Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Yong Sung Kim
- Department of Neurology, College of Medicine, Hanyang University, Wangsimni-ro 222, Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Jinseok Park
- Department of Neurology, College of Medicine, Hanyang University, Wangsimni-ro 222, Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Ki-Wook Oh
- Department of Neurology, College of Medicine, Hanyang University, Wangsimni-ro 222, Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Jung-Joon Sung
- Department of Translational Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | | | - Young-Eun Kim
- Department of Laboratory Medicine, College of Medicine, Hanyang University, Wangsimni-ro 222, Seongdong-gu, Seoul, 04763, Republic of Korea.
| | - Seung Hyun Kim
- Department of Neurology, College of Medicine, Hanyang University, Wangsimni-ro 222, Seongdong-gu, Seoul, 04763, Republic of Korea.
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Li J, Liu Q, Sun X, Zhang K, Liu S, Wang Z, Yang X, Liu M, Cui L, Zhang X. Genotype-phenotype association of TARDBP mutations in Chinese patients with amyotrophic lateral sclerosis: a single-center study and systematic review of published literature. J Neurol 2022; 269:4204-4212. [PMID: 35239007 DOI: 10.1007/s00415-022-11042-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/17/2022] [Accepted: 02/17/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study aims to determine the genetic and clinical features of TARDBP-mutated patients in our cohort of Chinese patients with amyotrophic lateral sclerosis (ALS) combined with data in the literature. METHODS We performed TARDBP mutation screening in 1258 Chinese ALS patients, including 1204 sporadic ALS (sALS) and 54 familial ALS (fALS) patients. A systematic literature review was conducted by searching TARDBP-mutated patients from China in the online databases. RESULTS In our cohort, the mutant frequency of TARDBP variants was 0.3% (4/1258), with two recurrent variants (p.G294V, p.G298V) and one novel variant (p.S332G) identified. Combining with data in the literature review, the TARDBP-mutant frequency in the Chinese population was 1.4% (83/5998), with 0.8% (46/5470) in sALS and 7.0% (37/528) in fALS. Most patients had limb onset (63.0%), with an average life expectancy of 4.3 years (range 0.5-13). Disease durations significantly differed (p = 0.002), with p.M337V showing the longest duration (80 months) and p.N378D showing the shortest duration (16.7 months). CONCLUSION Our study found that TARDBP mutation was not rare in Chinese fALS patients. Different TARDBP mutations were associated with specific features in phenotypes.
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Affiliation(s)
- Jinyue Li
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College (CAMS, PUMC), Beijing, China
| | - Qing Liu
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College (CAMS, PUMC), Beijing, China.
- Neuroscience Center, CAMS, Beijing, China.
| | - Xiaohan Sun
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College (CAMS, PUMC), Beijing, China
| | - Kang Zhang
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College (CAMS, PUMC), Beijing, China
| | - Shuangwu Liu
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College (CAMS, PUMC), Beijing, China
| | - Zhili Wang
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College (CAMS, PUMC), Beijing, China
| | - Xunzhe Yang
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College (CAMS, PUMC), Beijing, China
| | - Mingsheng Liu
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College (CAMS, PUMC), Beijing, China
| | - Liying Cui
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College (CAMS, PUMC), Beijing, China.
- Neuroscience Center, CAMS, Beijing, China.
| | - Xue Zhang
- McKusick-Zhang Center for Genetic Medicine, State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, CAMS, PUMC, Beijing, China
- Neuroscience Center, CAMS, Beijing, China
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Liu W, Li X, Sun Y, Yu X, Wang Y, Liu N, Deng M. Genotype-phenotype correlations in a chinese population with familial amyotrophic lateral sclerosis. Neurol Res 2021; 44:206-216. [PMID: 34431456 DOI: 10.1080/01616412.2021.1968706] [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: 10/20/2022]
Abstract
Objective: This study aimed to determine the distribution of the most commonly mutated genes (SOD1, TARDBP, FUS/TLS, and C9ORF72) associated with familial amyotrophic lateral sclerosis (FALS) and the association between genotype and phenotype in 242 Chinese patients.Methods: A total of 58 families were screened for ALS-associated mutations in SOD1,TARDBP, FUS, and C9ORF72 hexanucleotide repeat expansion. These mutations were analyzed to evaluate the relationship between genotype and phenotype in Chinese FALS patients.Results: Partial clinical data were obtained for 242 relatives of the 58 analyzed families, with a male-to-female ratio of 1.2:1 and a mean age of disease onset of 45.9±12.0 (13-80) years. 26 mutations associated with pathogenesis were identified in 32 probands from 58 different families. Mutations in SOD1, FUS, TARDBP, and C9ORF72 accounted for 32.8%, 12.1%, 8.6%, and 1.7% of FALS, respectively. FALS patients showed longer survival times; however, bulbar-onset ALS and the male-to-female ratio for them were lower than those reported previously. The site of onset, age of onset, and lifespan differed in FALS patients with SOD1, TARDBP, and FUS mutations.Discussion: In this study, patients with SOD1 mutations exhibited heterogeneous survival times that showed a bimodal distribution, while patients with FUS mutations showed rapid disease progression. Our results showed the relative contributions of the different types of mutations associated with ALS and provided phenotype-genotype correlations with clinical features in Chinese patients.
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Affiliation(s)
- WenChao Liu
- Institute of Medical Innovation and Research, Peking University Third Hospital, Beijing, China
| | - XiaoGang Li
- Department of Neurology, Peking University Third Hospital, Beijing, China
| | - Yan Sun
- Institute of Medical Innovation and Research, Peking University Third Hospital, Beijing, China
| | - XiaoTong Yu
- Institute of Medical Innovation and Research, Peking University Third Hospital, Beijing, China
| | - Yan Wang
- Institute of Medical Innovation and Research, Peking University Third Hospital, Beijing, China
| | - Na Liu
- Department of Neurology, Peking University Third Hospital, Beijing, China
| | - Min Deng
- Institute of Medical Innovation and Research, Peking University Third Hospital, Beijing, China
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Feng F, Wang H, Liu J, Wang Z, Xu B, Zhao K, Tao X, He Z, Yang F, Huang X. Genetic and clinical features of Chinese sporadic amyotrophic lateral sclerosis patients with TARDBP mutations. Brain Behav 2021; 11:e2312. [PMID: 34333853 PMCID: PMC8413724 DOI: 10.1002/brb3.2312] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/06/2021] [Accepted: 07/14/2021] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES To investigate the genetic and clinical features of Chinese sporadic amyotrophic lateral sclerosis (SALS) patients with TARDBP mutations, we carried out a genetic analysis in a cohort of 391 SALS patients and explored the clinical manifestations of patients with TARDBP variants. MATERIALS AND METHODS The coding region of all five coding exons of TARDBP, exons 2-6, were sequenced for mutations in 391 Chinese SALS patients. The clinical features of patients with TARDBP mutations were described and compared with cases in literatures. RESULTS Two missense mutations in TARDBP gene, c.1132A > G (p.N378D) and c.1147A > G (p.I383V), were detected in three cases, showing a low frequency (0.77%, 3/391) of TARDBP missense mutations in Chinese SALS patients. Based on a retrospective analysis of literatures, p.N378D mutation mainly presents a phenotype of early onset, whereas p.I383V mutation presents pure ALS or ALS alongside semantic variant primary progressive aphasia (svPPA), a type of frontotemporal dementia (FTD). CONCLUSIONS Our results demonstrate that TARDBP mutation is a rare cause of Chinese SALS patients and expand the spectrum of phenotype. It is implied that genetic analysis of SALS patients plays a crucial role in uncovering the cause of disease, especially for cases developing early onset or alongside FTD.
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Affiliation(s)
- Feng Feng
- Department of Neurology, First Medical Center, Chinese PLA General Hospital, Beijing, China.,Department of Neurology, PLA Rocket Force Characteristic Medical Center, Beijing, China
| | - Hongfen Wang
- Department of Neurology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Jiajin Liu
- Department of Nuclear Medicine, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Zhanjun Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Baixuan Xu
- Department of Nuclear Medicine, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Kun Zhao
- School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Xiaoyong Tao
- Department of Neurology, Eighth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Zhengqing He
- Department of Neurology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Fei Yang
- Department of Neurology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Xusheng Huang
- Department of Neurology, First Medical Center, Chinese PLA General Hospital, Beijing, China
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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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Wei Q, Zhou Q, Chen Y, Ou R, Cao B, Xu Y, Yang J, Shang HF. Analysis of SOD1 mutations in a Chinese population with amyotrophic lateral sclerosis: a case-control study and literature review. Sci Rep 2017; 7:44606. [PMID: 28291249 PMCID: PMC5349524 DOI: 10.1038/srep44606] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 02/09/2017] [Indexed: 02/05/2023] Open
Abstract
Although the copper/zinc superoxide dismutase-1 (SOD1) gene has been identified in both familial ALS (FALS) and sporadic ALS (SALS), it has rarely been studied in Chinese patients with ALS, and there are few studies with large samples. This study sought to assess the prevalence of SOD1 mutations in Chinese ALS patients. We screened a cohort of 499 ALS patients (487 SALS and 12 FALS) from the Department of Neurology at the West China Hospital of Sichuan University and analyzed all coding exons of SOD1 by Sanger sequencing. In addition, we reviewed the mutation frequencies of common ALS causative genes in Chinese populations. Eight missense mutations in SOD1 were found in 8 ALS individuals: two novel mutations (p.G73D and p.V120F) and six previously reported mutations. The frequencies of SOD1 mutations were 1.03% (5/487) in SALS and 25% (3/12) in FALS from Southwest China. A literature review indicated that the mutation rates of major ALS causative genes were 53.55% in FALS and 6.29% in SALS. In Chinese SALS and FALS, the highest mutation frequency was in the SOD1 gene. Our results suggest that SOD1 mutation is the most common cause of ALS in Chinese populations and that the mutation spectrum of ALS varies among different ethnic populations.
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Affiliation(s)
- QianQian Wei
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - QingQing Zhou
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - YongPing Chen
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - RuWei Ou
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Bei Cao
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - YaQian Xu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jing Yang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hui-Fang Shang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Abstract
TDP-43 is a dimeric nuclear protein that plays a central role in RNA metabolism. In recent years, this protein has become a focal point of research in the amyotrophic lateral sclerosis and frontotemporal dementia (ALS/FTD) disease spectrum, as pathognomonic inclusions within affected neurons contain post-translationally modified TDP-43. A key question in TDP-43 research involves determining the mechanisms and triggers that cause TDP-43 to form pathological aggregates. This review gives a brief overview of the physiological and pathological roles of TDP-43 and focuses on the structural features of its protein domains and how they may contribute to normal protein function and to disease. A special emphasis is placed on the C-terminal prion-like region thought to be implicated in pathology, as it is where nearly all ALS/FTD-associated mutations reside. Recent structural studies of this domain revealed its crucial role in the formation of phase-separated liquid droplets through a partially populated α-helix. This new discovery provides further support for the theory that liquid droplets such as stress granules may be precursors to pathological aggregates, linking environmental effects such as stress to the potential etiology of the disease. The transition of TDP-43 among soluble, droplet, and aggregate phases and the implications of these transitions for pathological aggregation are summarized and discussed.
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Affiliation(s)
- Yulong Sun
- Department of Medical Biophysics, University of Toronto , Toronto, Ontario M5G1L7, Canada
| | - Avijit Chakrabartty
- Department of Medical Biophysics, University of Toronto , Toronto, Ontario M5G1L7, Canada.,Department of Biochemistry, University of Toronto , Toronto, Ontario M5G1L7, Canada
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McCombe PA, Wray NR, Henderson RD. Extra-motor abnormalities in amyotrophic lateral sclerosis: another layer of heterogeneity. Expert Rev Neurother 2017; 17:561-577. [PMID: 27983884 DOI: 10.1080/14737175.2017.1273772] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease defined by the presence of muscle weakness. The motor features of disease are heterogeneous in site of onset and progression. There are also extra-motor features in some patients. The genetic basis for extra-motor features is uncertain. The heterogeneity of ALS is an issue for clinical trials. Areas covered: This paper reviews the range and prevalence of extra-motor features associated with ALS, and highlights the current information about genetic associations with extra-motor features. Expert commentary: There are extra-motor features of ALS, but these are not found in all patients. The most common is cognitive abnormality. More data is required to ascertain whether extra-motor features arise with progression of disease. Extra-motor features are reported in patients with a range of causative genetic mutations, but are not found in all patients with these mutations. Further studies are required of the heterogeneity of ALS, and genotype/phenotype correlations are required, taking note of extra-motor features.
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Affiliation(s)
- P A McCombe
- a The University of Queensland Centre for Clinical Research and Department of Neurology, Royal Brisbane and Women's Hospital , Brisbane , Australia
| | - N R Wray
- b The University of Queensland Institute for Molecular Bioscience , Brisbane , Australia
| | - R D Henderson
- a The University of Queensland Centre for Clinical Research and Department of Neurology, Royal Brisbane and Women's Hospital , Brisbane , Australia
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