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Clarke MTM, St-Onge F, Beauregard JM, Bocchetta M, Todd E, Cash DM, Rohrer JD, Laforce R. Early anterior cingulate involvement is seen in presymptomatic MAPT P301L mutation carriers. ALZHEIMERS RESEARCH & THERAPY 2021; 13:42. [PMID: 33568215 PMCID: PMC7876816 DOI: 10.1186/s13195-021-00777-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 01/25/2021] [Indexed: 12/12/2022]
Abstract
Background PET imaging of glucose metabolism has revealed presymptomatic abnormalities in genetic FTD but has not been explored in MAPT P301L mutation carriers. This study aimed to explore the patterns of presymptomatic hypometabolism and atrophy in MAPT P301L mutation carriers. Methods Eighteen asymptomatic members from five families with a P301L MAPT mutation were recruited to the study, six mutation carriers, and twelve mutation-negative controls. All participants underwent standard behavioural and cognitive assessment as well as [18F]FDG-PET and 3D T1-weighted MRI brain scans. Regional standardised uptake value ratios (SUVR) for the PET scan and volumes calculated from an automated segmentation for the MRI were obtained and compared between the mutation carrier and control groups. Results The mean (standard deviation) estimated years from symptom onset was 12.5 (3.6) in the mutation carrier group with a range of 7 to 18 years. No differences in cognition were seen between the groups, and all mutation carriers had a global CDR plus NACC FTLD of 0. Significant reduction in [18F] FDG uptake in the anterior cingulate was seen in mutation carriers (mean 1.25 [standard deviation 0.07]) compared to controls (1.36 [0.09]). A similar significant reduction was also seen in grey matter volume in the anterior cingulate in mutation carriers (0.60% [0.06%]) compared to controls (0.68% [0.08%]). No other group differences were seen in other regions. Conclusions Anterior cingulate hypometabolism and atrophy are both apparent presymptomatically in a cohort of P301L MAPT mutation carriers. Such a specific marker may prove to be helpful in stratification of presymptomatic mutation carriers in future trials. Supplementary Information The online version contains supplementary material available at 10.1186/s13195-021-00777-9.
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Affiliation(s)
- Mica T M Clarke
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK.
| | - Frédéric St-Onge
- Centre de Recherche du CHU de Québec, Université Laval, Québec, QC, Canada.,Clinique Interdisciplinaire de Mémoire (CIME), Département des Sciences Neurologiques, CHU de Québec-Université Laval, Québec, QC, Canada.,Faculté de Médecine, Département de médecine, Université Laval, Québec, QC, Canada
| | | | - Martina Bocchetta
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Emily Todd
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - David M Cash
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Robert Laforce
- Centre de Recherche du CHU de Québec, Université Laval, Québec, QC, Canada.,Clinique Interdisciplinaire de Mémoire (CIME), Département des Sciences Neurologiques, CHU de Québec-Université Laval, Québec, QC, Canada.,Faculté de Médecine, Département de médecine, Université Laval, Québec, QC, Canada.,CHU de Québec, Québec, QC, Canada
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Abstract
Frontotemporal dementia (FTD) is the second commonest cause of young onset dementia. Our understanding of FTD and its related syndromes has advanced significantly in recent years. Among the most prominent areas of progress is the overlap between FTD, MND, and other neurodegenerative conditions at a clinicopathologic and genetic level. In parallel major advances in neuroimaging techniques, the discovery of new genetic mutations as well as the development of potential biomarkers may serve to further expand knowledge of the biologic processes at play in FTD and may in turn propel research toward identifying curative and preventative pharmacologic therapies. The aim of this chapter is to discuss the clinical, pathologic, and genetic complexities of FTD and related disorders.
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Affiliation(s)
- Emma M Devenney
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Rebekah M Ahmed
- Department of Clinical Neuroscience, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - John R Hodges
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia.
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3
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He S, Chen S, Xia MR, Sun ZK, Huang Y, Zhang JW. The role of MAPT gene in Chinese dementia patients: a P301L pedigree study and brief literature review. Neuropsychiatr Dis Treat 2018; 14:1627-1633. [PMID: 29950844 PMCID: PMC6018486 DOI: 10.2147/ndt.s155521] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND AND PURPOSE Frontotemporal dementia (FTD) is the second most common presenile dementia characterized by behavioral changes and language impairment. The diagnosis of FTD relies heavily on neuroimaging, and sometimes on genetic screening. However, the genetic components in Chinese FTD patients remain largely unknown. Only a few FTD cases with established mutations have been reported in China. This study reported the detailed clinical and neuroimaging features in a Chinese behavioral variant FTD family. The role of MAPT gene mutation in Chinese dementia patients was also reviewed. METHODS By detailed inquiry of all affected individuals in the family, this study summarized the main clinical features of the disease. Four candidate genes (MAPT, PSEN1, PSEN2, and APP) were screened by direct sequencing. Structural magnetic resonance imaging (MRI), functional imaging of cerebral blood flow with arterial spin-labeled MRI (ASL-MRI), and cerebral metabolism with fluorodeoxyglucose positron emission tomography (FDG-PET) were collected in the proband and healthy mutation carriers. RESULTS By direct sequencing of candidate genes (MAPT, PSEN1, PSEN2, and APP), this study identified the P301L mutation in the MAPT gene in the proband and three unaffected family members. The phenotype of the affected cases was consistent within the pedigree. In this genetically proven behavioral variant FTD (bvFTD) patient, the maps of hypoperfusion on ASL-MRI look fairly similar to the hypometabolism on FDG-PET. The clinical feature for this bvFTD was in line with the hypoperfusion or hypometabolism pattern on functional neuroimagings. The phenotype of P301L in east Asia seems similar to western countries. CONCLUSION For the inherited FTD patients, ASL-MRI and genetic identification were strongly recommended for the final diagnosis. In case of being underestimated, the role of MAPT gene mutation in Chinese FTD patients warrants further investigation.
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Affiliation(s)
- Shuang He
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, Henan, 450003, China
| | - Shuai Chen
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, Henan, 450003, China
| | - Ming-Rong Xia
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, Henan, 450003, China
| | - Zhi-Kun Sun
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, Henan, 450003, China
| | - Yue Huang
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, Henan, 450003, China
| | - Jie-Wen Zhang
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, Henan, 450003, China
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Miki T, Yokota O, Takenoshita S, Mori Y, Yamazaki K, Ozaki Y, Ueno SI, Haraguchi T, Ishizu H, Kuroda S, Terada S, Yamada N. Frontotemporal lobar degeneration due to P301L tau mutation showing apathy and severe frontal atrophy but lacking other behavioral changes: A case report and literature review. Neuropathology 2017; 38:268-280. [PMID: 29105852 DOI: 10.1111/neup.12441] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Revised: 10/05/2017] [Accepted: 10/05/2017] [Indexed: 12/23/2022]
Abstract
The clinical features in cases that have mutations in the microtubule-associated protein tau gene but lack prominent behavioral changes remain unclear. Here, we describe detailed clinical and pathological features of a case carrying the P301L tau mutation that showed only apathy until the middle stage of the course. The mother of this case was suspected to have mild cognitive decline at age 46. However, before she was fully examined, she had a subarachnoid hemorrhage at age 49 and died at age 53. An autopsy was not done. The proband of this pedigree, a 60-year-old right-handed Japanese man at the time of death, began to make mistakes at work at the age of 51 years. Until age 54, he showed only mild apathy with bradykinesia. Insight was well spared. Parkinsonism and echolalia developed at age 55, and pyramidal signs and oral tendency at age 57. Personality change, disinhibition, stereotypy, or semantic memory impairment was not found throughout the course. The final neurological diagnosis was unspecified dementia. Pathological examination demonstrated numerous round four-repeat tau-positive three-repeat tau-negative or perinuclear ring-like neuronal cytoplasmic inclusions with many ballooned neurons in the frontal and temporal cortices and hippocampus. Genetic analysis using frozen brain tissue demonstrated a P301L tau mutation. Among 31 previously reported cases bearing the P301L tau mutation for which the data regarding initial symptoms are available, one clinical case showed only apathy with depression in the early stage. Given these findings, clinicians should be aware that a clinical course characterized only by apathy for several years, which can be misdiagnosed as a psychiatric disorder, is one of the clinical presentations associated with P301L tau mutation.
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Affiliation(s)
- Tomoko Miki
- Department of Neuropsychiatry; Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences; Okayama Japan
- Department of Psychiatry; Kinoko Espoir Hospital; Okayama Japan
- Department of Psychiatry; Zikei Hospital; Okayama Japan
| | - Osamu Yokota
- Department of Neuropsychiatry; Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences; Okayama Japan
- Department of Psychiatry; Kinoko Espoir Hospital; Okayama Japan
- Department of Psychiatry; Zikei Hospital; Okayama Japan
| | - Shintaro Takenoshita
- Department of Neuropsychiatry; Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences; Okayama Japan
| | - Yoko Mori
- Department of Neuropsychiatry; Ehime University Graduate School of Medicine; Ehime Japan
| | - Kiyohiro Yamazaki
- Department of Neuropsychiatry; Ehime University Graduate School of Medicine; Ehime Japan
| | - Yuki Ozaki
- Department of Neuropsychiatry; Ehime University Graduate School of Medicine; Ehime Japan
| | - Shu-ichi Ueno
- Department of Neuropsychiatry; Ehime University Graduate School of Medicine; Ehime Japan
| | - Takashi Haraguchi
- Department of Neurology; National Hospital Organization Minami-Okayama Medical Center; Okayama Japan
| | - Hideki Ishizu
- Department of Psychiatry; Zikei Hospital; Okayama Japan
- Department of Laboratory Medicine and Pathology; Zikei Institute of Psychiatry; Okayama Japan
| | - Shigetoshi Kuroda
- Department of Psychiatry; Zikei Hospital; Okayama Japan
- Department of Laboratory Medicine and Pathology; Zikei Institute of Psychiatry; Okayama Japan
| | - Seishi Terada
- Department of Neuropsychiatry; Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences; Okayama Japan
| | - Norihito Yamada
- Department of Neuropsychiatry; Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences; Okayama Japan
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Tacik P, Sanchez-Contreras M, DeTure M, Murray ME, Rademakers R, Ross OA, Wszolek ZK, Parisi JE, Knopman DS, Petersen RC, Dickson DW. Clinicopathologic heterogeneity in frontotemporal dementia and parkinsonism linked to chromosome 17 (FTDP-17) due to microtubule-associated protein tau (MAPT) p.P301L mutation, including a patient with globular glial tauopathy. Neuropathol Appl Neurobiol 2017; 43:200-214. [PMID: 27859539 DOI: 10.1111/nan.12367] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 10/13/2016] [Accepted: 10/31/2016] [Indexed: 12/11/2022]
Abstract
AIM The p.P301L mutation in microtubule-associated protein tau (MAPT) is a common cause of frontotemporal dementia and parkinsonism linked to chromosome 17 (FTDP-17). We compare clinicopathologic features of five unrelated and three related (brother, sister and cousin) patients with FTDP-17 due to p.P301L mutation. METHODS Genealogical, clinical, neuropathologic and genetic data were reviewed from eight individuals. RESULTS The series consisted of five men and three women with an average age of death of 58 years (52-65 years) and average disease duration of 9 years (3-14 years). The first symptoms were those of behavioural variant frontotemporal dementia in seven patients and semantic variant of primary progressive aphasia in one. Three patients were homozygous for the MAPT H1 haplotype; five had H1/H2 genotype. The apolipoprotein E genotype was ϵ3/ϵ3 in seven and ϵ3/ϵ4 in one. The average brain weight was 1015 g (876-1188 g). All had frontotemporal lobar or more diffuse cortical atrophy. Except for one patient, the hippocampus and parahippocampal gyrus had minimal atrophy, whereas there was atrophy of middle and inferior temporal gyri. Dentate fascia neuronal dispersion was identified in three patients, two of whom had epilepsy. In one patient there was extensive white matter tau involvement with Gallyas-positive globular glial inclusions typical of globular glial tauopathy (GGT). CONCLUSIONS This clinicopathologic study shows inter- and intra-familial clinicopathologic heterogeneity of FTDP-17 due to MAPT p.P301L mutation, including GGT in one patient.
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Affiliation(s)
- P Tacik
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | | | - M DeTure
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | - M E Murray
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | - R Rademakers
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | - O A Ross
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | - Z K Wszolek
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - J E Parisi
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - D S Knopman
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - R C Petersen
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - D W Dickson
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
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Fontaine SN, Sabbagh JJ, Baker J, Martinez-Licha CR, Darling A, Dickey CA. Cellular factors modulating the mechanism of tau protein aggregation. Cell Mol Life Sci 2015; 72:1863-79. [PMID: 25666877 DOI: 10.1007/s00018-015-1839-9] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 12/18/2014] [Accepted: 01/13/2015] [Indexed: 01/12/2023]
Abstract
Pathological accumulation of the microtubule-associated protein tau, in the form of neurofibrillary tangles, is a major hallmark of Alzheimer's disease, the most prevalent neurodegenerative condition worldwide. In addition to Alzheimer's disease, a number of neurodegenerative diseases, called tauopathies, are characterized by the accumulation of aggregated tau in a variety of brain regions. While tau normally plays an important role in stabilizing the microtubule network of the cytoskeleton, its dissociation from microtubules and eventual aggregation into pathological deposits is an area of intense focus for therapeutic development. Here we discuss the known cellular factors that affect tau aggregation, from post-translational modifications to molecular chaperones.
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Affiliation(s)
- Sarah N Fontaine
- Department of Molecular Medicine, College of Medicine, Byrd Alzheimer's Institute, University of South Florida, Tampa, FL, 33613, USA
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Ghetti B, Oblak AL, Boeve BF, Johnson KA, Dickerson BC, Goedert M. Invited review: Frontotemporal dementia caused by microtubule-associated protein tau gene (MAPT) mutations: a chameleon for neuropathology and neuroimaging. Neuropathol Appl Neurobiol 2015; 41:24-46. [PMID: 25556536 PMCID: PMC4329416 DOI: 10.1111/nan.12213] [Citation(s) in RCA: 305] [Impact Index Per Article: 33.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 12/29/2014] [Indexed: 12/12/2022]
Abstract
Hereditary frontotemporal dementia associated with mutations in the microtubule-associated protein tau gene (MAPT) is a protean disorder. Three neuropathologic subtypes can be recognized, based on the presence of inclusions made of tau isoforms with three and four repeats, predominantly three repeats and mostly four repeats. This is relevant for establishing a correlation between structural magnetic resonance imaging and positron emission tomography using tracers specific for aggregated tau. Longitudinal studies will be essential to determine the evolution of anatomical alterations from the asymptomatic stage to the various phases of disease following the onset of symptoms.
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Affiliation(s)
- B Ghetti
- Department of Pathology and Laboratory Medicine, Indiana University School of MedicineIndianapolis, USA
| | - A L Oblak
- Department of Pathology and Laboratory Medicine, Indiana University School of MedicineIndianapolis, USA
| | - B F Boeve
- Department of Neurology, Mayo ClinicRochester, USA
| | - K A Johnson
- Department of Radiology, Massachusetts General Hospital and Harvard Medical SchoolBoston, USA
- Department of Neurology, Massachusetts General Hospital and Harvard Medical SchoolBoston, USA
| | - B C Dickerson
- Department of Neurology, Massachusetts General Hospital and Harvard Medical SchoolBoston, USA
| | - M Goedert
- Medical Research Council, Laboratory of Molecular BiologyCambridge, UK
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8
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Sitek EJ, Narozanska E, Barczak A, Jasinska-Myga B, Harciarek M, Chodakowska-Zebrowska M, Kubiak M, Wieczorek D, Konieczna S, Rademakers R, Baker M, Berdynski M, Brockhuis B, Barcikowska M, Zekanowski C, Heilman KM, Wszolek ZK, Slawek J. Agraphia in patients with frontotemporal dementia and parkinsonism linked to chromosome 17 with P301L MAPT mutation: dysexecutive, aphasic, apraxic or spatial phenomenon? Neurocase 2014; 20:69-86. [PMID: 23121543 PMCID: PMC3710298 DOI: 10.1080/13554794.2012.732087] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Patients with frontotemporal dementia and parkinsonism linked to chromosome 17 (FTDP-17) may be agraphic. The study aimed at characterizing agraphia in individuals with a P301L MAPT mutation. METHODS Two pairs of siblings with FTDP-17 were longitudinally examined for agraphia in relation to language and cognitive deficits. RESULTS All patients presented with dysexecutive agraphia. In addition, in the first pair of siblings one sibling demonstrated spatial agraphia with less pronounced allographic agraphia and the other sibling had aphasic agraphia. Aphasic agraphia was also present in one sibling from the second pair. CONCLUSION Agraphia associated with FTDP-17 is very heterogeneous.
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Affiliation(s)
- Emilia J Sitek
- a Department of Neurology , St. Adalbert Hospital , Gdansk , Poland
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Whitwell JL, Jack CR, Boeve BF, Senjem ML, Baker M, Ivnik RJ, Knopman DS, Wszolek ZK, Petersen RC, Rademakers R, Josephs KA. Atrophy patterns in IVS10+16, IVS10+3, N279K, S305N, P301L, and V337M MAPT mutations. Neurology 2009; 73:1058-65. [PMID: 19786698 DOI: 10.1212/wnl.0b013e3181b9c8b9] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE To use a case-control study to assess and compare patterns of gray matter loss across groups of subjects with different mutations in the microtubule-associated protein tau (MAPT) gene. METHODS We identified all subjects from Mayo Clinic, Rochester, Minnesota, that screened positive for mutations in MAPT and had a head MRI (n = 22). Voxel-based morphometry was used to assess patterns of gray matter atrophy in groups of subjects with the IVS10+16, IVS10+3, N279K, S305N, P301L, and V337M mutations compared with age- and sex-matched controls. RESULTS All MAPT groups showed gray matter loss in the anterior temporal lobes, with varying degrees of involvement of the frontal and parietal lobes. Within the temporal lobe, the subjects with IVS10+16, IVS10+3, N279K, and S305N mutations (mutations that influence the alternative splicing of tau pre-messenger RNA) all showed gray matter loss focused on the medial temporal lobes. In contrast to these groups, the subjects with P301L or V337M mutations (mutations that affect the structure of the tau protein) both showed gray matter loss focused on the lateral temporal lobes, with a relative sparing of the medial temporal lobe. CONCLUSION There seem to be differences in patterns of temporal lobe atrophy across the MAPT mutations, which may aid in the differentiation of the different mutation carriers. Furthermore, there seems to be a possible association between mutation function and pattern of temporal lobe atrophy.
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Affiliation(s)
- J L Whitwell
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
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Neuropathology of Hereditary Forms of Frontotemporal Dementia and Parkinsonism. HANDBOOK OF CLINICAL NEUROLOGY 2008; 89:393-414. [DOI: 10.1016/s0072-9752(07)01237-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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12
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Abstract
Tau protein is involved in microtubule assembly and stabilization. Filamentous deposits made of tau constitute a defining characteristic of several neurodegenerative diseases. The relevance of tau dysfunction for neurodegeneration has been clarified through the identification of mutations in the Tau gene in cases with frontotemporal dementia and parkinsonism linked to chromosome 17 (FTDP-17). Although the mechanisms by which these mutations lead to nerve cell death are only incompletely understood, it is clear that they cause the formation of tau filaments with distinct morphologies and isoform compositions. The range of tau pathology identified in FTDP-17 recapitulates that in sporadic tauopathies, indicating a major role for tau dysfunction in these diseases.
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Frontotemporal dementia with parkinsonism linked to Chromosome 17. NEURODEGENER DIS 2005. [DOI: 10.1017/cbo9780511544873.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Walker RH, Friedman J, Wiener J, Hobler R, Gwinn-Hardy K, Adam A, DeWolfe J, Gibbs R, Baker M, Farrer M, Hutton M, Hardy J. A family with a tau P301L mutation presenting with parkinsonism. Parkinsonism Relat Disord 2002; 9:121-3. [PMID: 12473404 DOI: 10.1016/s1353-8020(02)00003-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
We report a sib-pair with a tau P301L mutation. Unlike most previous cases with this mutation, parkinsonism, rather than dementing features were the predominant and presenting feature. We have also observed that the P301L mutation has occurred on the H1 tau haplotype background. The haplotype background may influence the disease phenotype since in many previous Caucasian families with the P301L mutation, the haplotype background has been H2.
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Affiliation(s)
- Ruth H Walker
- Department of Neurology, Bronx VA Medical Center, NY 10468, USA
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Abstract
The defining neuropathological characteristics of Alzheimer's disease are abundant filamentous tau lesions and deposits of fibrillar amyloid beta peptides. Prominent filamentous tau inclusions and brain degeneration in the absence of beta-amyloid deposits are also hallmarks of neurodegenerative tauopathies exemplified by sporadic corticobasal degeneration, progressive supranuclear palsy, and Pick's disease, as well as by hereditary frontotemporal dementia and parkinsonism linked to chromosome 17 (FTDP-17). Because multiple tau gene mutations are pathogenic for FTDP-17 and tau polymorphisms appear to be genetic risk factors for sporadic progressive supranuclear palsy and corticobasal degeneration, tau abnormalities are linked directly to the etiology and pathogenesis of neurodegenerative disease. Indeed, emerging data support the hypothesis that different tau gene mutations are pathogenic because they impair tau functions, promote tau fibrillization, or perturb tau gene splicing, thereby leading to formation of biochemically and structurally distinct aggregates of tau. Nonetheless, different members of the same kindred often exhibit diverse FTDP-17 syndromes, which suggests that additional genetic or epigenetic factors influence the phenotypic manifestations of neurodegenerative tauopathies. Although these and other hypothetical mechanisms of neurodegenerative tauopathies remain to be tested and validated, transgenic models are increasingly available for this purpose, and they will accelerate discovery of more effective therapies for neurodegenerative tauopathies and related disorders, including Alzheimer's disease.
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Affiliation(s)
- V M Lee
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA.
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Abstract
Tau plays an important role in movement disorders. The accumulation of pathological tau is a major substrate of frontotemporal dementia and parkinsonism linked to chromosome 17, progressive supranuclear palsy, and corticobasal degeneration. Over the past year, several new mutations on the tau gene have been found. These mutations have been classified into three groups: (i) mutations in constitutively spliced exons; (ii) mutations in the alternatively spliced exon 10; and (iii) mutations of the exon 10 5' splice site. Some patients presenting with frontotemporal dementia and parkinsonism linked to chromosome 17 transiently respond to levodopa therapy. The significance of Pick bodies was recognized by a recent study on kindred with the Glu342Val tau mutation. In sporadic cases of progressive supranuclear palsy, the presence of the H1 haplotype was found to be a risk factor. Corticobasal degeneration shares a common genetic background with progressive supranuclear palsy. This opens the question of whether corticobasal degeneration represents a separate disorder or a spectrum of disease with progressive supranuclear palsy. However, distinguishing features are observed, and include oculomotor abnormalities, which may help to differentiate these two disorders on clinical grounds. Despite recent advances in the understanding of the tauopathies, there are still no curative therapies available. It is hoped that studies in transgenic tau animal models will lead to the development of successful treatments.
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