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Pathogenic Huntingtin Repeat Expansions in Patients with Frontotemporal Dementia and Amyotrophic Lateral Sclerosis

  • The PROSPECT Consortium
  • , The American Genome Center (TAGC)
  • , The FALS Sequencing Consortium
  • , The Genomics England Research Consortium
  • , The International ALS/FTD Genomics Consortium (iAFGC)
  • , The International FTD Genetics Consortium (IFGC)
  • , The International LBD Genomics Consortium (iLBDGC), The NYGC ALS Consortium
  • , the University of Maryland Brain and Tissue Bank and NIH NeuroBioBank
  • National Institutes of Health
  • Columbia University
  • Boston University
  • Department of Veterans Affairs
  • VA Medical Center
  • University College London
  • Queen Mary University of London
  • University of Massachusetts Medical School
  • IRCCS Fondazione Istituto Neurologico Carlo Besta - Milano
  • Lund University
  • University of Gothenburg
  • University of Turin
  • National Research Council of Italy
  • Azienda Ospedaliera - Universitaria Città della Salute e della Scienza di Torino
  • Royal Free London NHS Foundation Trust
  • University of Cambridge
  • IRCCS Centro San Giovanni di Dio Fatebenefratelli - Brescia
  • Uniformed Services University of the Health Sciences
  • Emory University
  • IRCCS Istituto Auxologico Italiano - Milano
  • University of Milan
  • Mayo Clinic College of Medicine and Science
  • Scripps Research Institute
  • University of Manchester
  • University College London Hospitals NHS Foundation Trust
  • Hong Kong University of Science and Technology
  • University of Pennsylvania
  • Johns Hopkins University

Research output: Contribution to journalArticlepeer-review

80 Scopus citations

Abstract

We examined the role of repeat expansions in the pathogenesis of frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS) by analyzing whole-genome sequence data from 2,442 FTD/ALS patients, 2,599 Lewy body dementia (LBD) patients, and 3,158 neurologically healthy subjects. Pathogenic expansions (range, 40–64 CAG repeats) in the huntingtin (HTT) gene were found in three (0.12%) patients diagnosed with pure FTD/ALS syndromes but were not present in the LBD or healthy cohorts. We replicated our findings in an independent collection of 3,674 FTD/ALS patients. Postmortem evaluations of two patients revealed the classical TDP-43 pathology of FTD/ALS, as well as huntingtin-positive, ubiquitin-positive aggregates in the frontal cortex. The neostriatal atrophy that pathologically defines Huntington's disease was absent in both cases. Our findings reveal an etiological relationship between HTT repeat expansions and FTD/ALS syndromes and indicate that genetic screening of FTD/ALS patients for HTT repeat expansions should be considered.

Original languageEnglish
Pages (from-to)448-460.e4
JournalNeuron
Volume109
Issue number3
DOIs
StatePublished - 3 Feb 2021

Funding

FundersFunder number
Huntington's Disease Society of America
Hereditary Disease Foundation
Lewy Body Dementia Association
National Human Genome Research Institute
National Institute for Health and Care Research
National Institutes of Health
European Commission
NIHR Cambridge Biomedical Research Centre
Tow Foundation
Cerevel Therapeutics
American Journal of Neurodegenerative Diseases, and Frontiers in Neurology
National Institute on AgingZIAAG000934, P30AG013854, P30AG066507, ZIAAG000957, P01AG066597, ZIAAG000185, K08AG065463, P30AG066514, P30AG066462
U.S. Department of Veterans AffairsI01BX002466
UK Research and InnovationG0400074
National Institute of Neurological Disorders and Stroke1ZIAAG000935, 1ZIANS0030033, R01NS073873, ZIANS003154, 1ZIANS003034, R01NS115144
Medical Research CouncilMR/R011354/1, MR/L501529/1
Seventh Framework Programme259867
National Heart, Lung, and Blood InstituteIAA-A-HL-007.001
ALS Association19-SI-459
Ministero della SaluteP30 AG066462-01
Wellcome Trust103838

    Keywords

    • amyotrophic lateral sclerosis
    • frontotemporal dementia
    • huntingtin
    • repeat expansions
    • whole-genome sequencing

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