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Mol MO, Wong TH, Melhem S, Basu S, Viscusi R, Galjart N, Rozemuller AJ, Fallini C, Landers JE, Kaat LD, Seelaar H, van Rooij JG, van Swieten JC. Novel TUBA4A Variant Associated With Familial Frontotemporal Dementia. Neurol Genet 2021; 7:e596. [PMID: 34169147 PMCID: PMC8221227 DOI: 10.1212/nxg.0000000000000596] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 04/06/2021] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Despite the strong genetic component of frontotemporal dementia (FTD), a substantial proportion of patients remain genetically unresolved. We performed an in-depth study of a family with an autosomal dominant form of FTD to investigate the underlying genetic cause. METHODS Following clinical and pathologic characterization of the family, genetic studies included haplotype sharing analysis and exome sequencing. Subsequently, we performed immunohistochemistry, immunoblotting, and a microtubule repolymerization assay to investigate the potential impact of the candidate variant in tubulin alpha 4a (TUBA4A). RESULTS The clinical presentation in this family is heterogeneous, including behavioral changes, parkinsonian features, and uncharacterized dementia. Neuropathologic examination of 2 patients revealed TAR DNA binding protein 43 (TDP-43) pathology with abundant dystrophic neurites and neuronal intranuclear inclusions, consistent with frontotemporal lobar degeneration-TDP type A. We identified a likely pathogenic variant in TUBA4A segregating with disease. TUBA4A encodes for α-tubulin, which is a major component of the microtubule network. Variants in TUBA4A have been suggested as a rare genetic cause of amyotrophic lateral sclerosis (ALS) and have sporadically been reported in patients with FTD without supporting genetic segregation. A decreased trend of TUBA4A protein abundance was observed in patients compared with controls, and a microtubule repolymerization assay demonstrated disrupted α-tubulin function. As opposed to variants found in ALS, TUBA4A variants associated with FTD appear more localized to the N-terminus, indicating different pathogenic mechanisms. CONCLUSIONS Our findings support the role of TUBA4A variants as rare genetic cause of familial FTD.
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Affiliation(s)
| | | | - Shamiram Melhem
- From the Department of Neurology (M.O.M., T.H.W., S.M., L.D.K., H.S.,
J.G.J.v.R., J.C.v.S.), and Department of Cell Biology (S.B., R.V., N.G.),
Erasmus Medical Center, Rotterdam; Department of Pathology (A.J.M.R.), Amsterdam
University Medical Center, Location VUmc, Amsterdam Neuroscience, the
Netherlands; Department of Cell and Molecular Biology (C.F.), University of
Rhode Island, Kingston; Department of Neurology (J.E.L.), University of
Massachusetts Medical School, Worcester; and Department of Clinical Genetics
(L.D.K.), Erasmus Medical Center, Rotterdam, the Netherlands
| | - Sreya Basu
- From the Department of Neurology (M.O.M., T.H.W., S.M., L.D.K., H.S.,
J.G.J.v.R., J.C.v.S.), and Department of Cell Biology (S.B., R.V., N.G.),
Erasmus Medical Center, Rotterdam; Department of Pathology (A.J.M.R.), Amsterdam
University Medical Center, Location VUmc, Amsterdam Neuroscience, the
Netherlands; Department of Cell and Molecular Biology (C.F.), University of
Rhode Island, Kingston; Department of Neurology (J.E.L.), University of
Massachusetts Medical School, Worcester; and Department of Clinical Genetics
(L.D.K.), Erasmus Medical Center, Rotterdam, the Netherlands
| | - Riccardo Viscusi
- From the Department of Neurology (M.O.M., T.H.W., S.M., L.D.K., H.S.,
J.G.J.v.R., J.C.v.S.), and Department of Cell Biology (S.B., R.V., N.G.),
Erasmus Medical Center, Rotterdam; Department of Pathology (A.J.M.R.), Amsterdam
University Medical Center, Location VUmc, Amsterdam Neuroscience, the
Netherlands; Department of Cell and Molecular Biology (C.F.), University of
Rhode Island, Kingston; Department of Neurology (J.E.L.), University of
Massachusetts Medical School, Worcester; and Department of Clinical Genetics
(L.D.K.), Erasmus Medical Center, Rotterdam, the Netherlands
| | - Niels Galjart
- From the Department of Neurology (M.O.M., T.H.W., S.M., L.D.K., H.S.,
J.G.J.v.R., J.C.v.S.), and Department of Cell Biology (S.B., R.V., N.G.),
Erasmus Medical Center, Rotterdam; Department of Pathology (A.J.M.R.), Amsterdam
University Medical Center, Location VUmc, Amsterdam Neuroscience, the
Netherlands; Department of Cell and Molecular Biology (C.F.), University of
Rhode Island, Kingston; Department of Neurology (J.E.L.), University of
Massachusetts Medical School, Worcester; and Department of Clinical Genetics
(L.D.K.), Erasmus Medical Center, Rotterdam, the Netherlands
| | - Annemieke J.M. Rozemuller
- From the Department of Neurology (M.O.M., T.H.W., S.M., L.D.K., H.S.,
J.G.J.v.R., J.C.v.S.), and Department of Cell Biology (S.B., R.V., N.G.),
Erasmus Medical Center, Rotterdam; Department of Pathology (A.J.M.R.), Amsterdam
University Medical Center, Location VUmc, Amsterdam Neuroscience, the
Netherlands; Department of Cell and Molecular Biology (C.F.), University of
Rhode Island, Kingston; Department of Neurology (J.E.L.), University of
Massachusetts Medical School, Worcester; and Department of Clinical Genetics
(L.D.K.), Erasmus Medical Center, Rotterdam, the Netherlands
| | - Claudia Fallini
- From the Department of Neurology (M.O.M., T.H.W., S.M., L.D.K., H.S.,
J.G.J.v.R., J.C.v.S.), and Department of Cell Biology (S.B., R.V., N.G.),
Erasmus Medical Center, Rotterdam; Department of Pathology (A.J.M.R.), Amsterdam
University Medical Center, Location VUmc, Amsterdam Neuroscience, the
Netherlands; Department of Cell and Molecular Biology (C.F.), University of
Rhode Island, Kingston; Department of Neurology (J.E.L.), University of
Massachusetts Medical School, Worcester; and Department of Clinical Genetics
(L.D.K.), Erasmus Medical Center, Rotterdam, the Netherlands
| | - John E. Landers
- From the Department of Neurology (M.O.M., T.H.W., S.M., L.D.K., H.S.,
J.G.J.v.R., J.C.v.S.), and Department of Cell Biology (S.B., R.V., N.G.),
Erasmus Medical Center, Rotterdam; Department of Pathology (A.J.M.R.), Amsterdam
University Medical Center, Location VUmc, Amsterdam Neuroscience, the
Netherlands; Department of Cell and Molecular Biology (C.F.), University of
Rhode Island, Kingston; Department of Neurology (J.E.L.), University of
Massachusetts Medical School, Worcester; and Department of Clinical Genetics
(L.D.K.), Erasmus Medical Center, Rotterdam, the Netherlands
| | - Laura Donker Kaat
- From the Department of Neurology (M.O.M., T.H.W., S.M., L.D.K., H.S.,
J.G.J.v.R., J.C.v.S.), and Department of Cell Biology (S.B., R.V., N.G.),
Erasmus Medical Center, Rotterdam; Department of Pathology (A.J.M.R.), Amsterdam
University Medical Center, Location VUmc, Amsterdam Neuroscience, the
Netherlands; Department of Cell and Molecular Biology (C.F.), University of
Rhode Island, Kingston; Department of Neurology (J.E.L.), University of
Massachusetts Medical School, Worcester; and Department of Clinical Genetics
(L.D.K.), Erasmus Medical Center, Rotterdam, the Netherlands
| | - Harro Seelaar
- From the Department of Neurology (M.O.M., T.H.W., S.M., L.D.K., H.S.,
J.G.J.v.R., J.C.v.S.), and Department of Cell Biology (S.B., R.V., N.G.),
Erasmus Medical Center, Rotterdam; Department of Pathology (A.J.M.R.), Amsterdam
University Medical Center, Location VUmc, Amsterdam Neuroscience, the
Netherlands; Department of Cell and Molecular Biology (C.F.), University of
Rhode Island, Kingston; Department of Neurology (J.E.L.), University of
Massachusetts Medical School, Worcester; and Department of Clinical Genetics
(L.D.K.), Erasmus Medical Center, Rotterdam, the Netherlands
| | - Jeroen G.J. van Rooij
- From the Department of Neurology (M.O.M., T.H.W., S.M., L.D.K., H.S.,
J.G.J.v.R., J.C.v.S.), and Department of Cell Biology (S.B., R.V., N.G.),
Erasmus Medical Center, Rotterdam; Department of Pathology (A.J.M.R.), Amsterdam
University Medical Center, Location VUmc, Amsterdam Neuroscience, the
Netherlands; Department of Cell and Molecular Biology (C.F.), University of
Rhode Island, Kingston; Department of Neurology (J.E.L.), University of
Massachusetts Medical School, Worcester; and Department of Clinical Genetics
(L.D.K.), Erasmus Medical Center, Rotterdam, the Netherlands
| | - John C. van Swieten
- From the Department of Neurology (M.O.M., T.H.W., S.M., L.D.K., H.S.,
J.G.J.v.R., J.C.v.S.), and Department of Cell Biology (S.B., R.V., N.G.),
Erasmus Medical Center, Rotterdam; Department of Pathology (A.J.M.R.), Amsterdam
University Medical Center, Location VUmc, Amsterdam Neuroscience, the
Netherlands; Department of Cell and Molecular Biology (C.F.), University of
Rhode Island, Kingston; Department of Neurology (J.E.L.), University of
Massachusetts Medical School, Worcester; and Department of Clinical Genetics
(L.D.K.), Erasmus Medical Center, Rotterdam, the Netherlands
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