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Published on: March 24, 2019
Novel types of frontotemporal lobar degeneration: beyond tau and TDP-43
Ian R A Mackenzie1, Manuela Neumann, Nigel J Cairns
1Department of Pathology and Laboratory Medicine, University of British Columbia and Vancouver General Hospital, 855 West 12th Avenue, Vancouver, BC, V5Z 1M9, Canada. ian.mackenzie@vch.ca
Abstract:
Most cases of frontotemporal lobar degeneration (FTLD) are characterized by the abnormal accumulation of either the microtubule-associated protein tau or the transactive response DNA-binding protein with M(r) 43 kDa, TDP-43 (FTLD-tau and FTLD-TDP, respectively). However, there remain ∼10% of cases, composed of a heterogenous collection of uncommon disorders, for which the molecular basis remains uncertain. In this review, we describe the characteristic genetic, clinical, and pathological features of the major tau/TDP-negative FTLD subtypes, with focus on recent advances in our understanding of their molecular basis. This includes the discovery that the pathological changes in atypical FTLD with ubiquitinated inclusions, neuronal intermediate filament inclusion disease, and basophilic inclusion body disease are immunoreactive for the fused in sarcoma (FUS) protein, resulting in the creation of a new molecular subgroup (FTLD-FUS), and studies clarifying the functional consequences of pathogenic CHMP2B mutations.
Insights
This review details rare frontotemporal lobar degeneration (FTLD) subtypes lacking tau or TDP-43. It highlights new discoveries, including FTLD-FUS and CHMP2B mutations, advancing understanding of these complex neurodegenerative diseases.
Area of Science:
- Neuroscience
- Neuropathology
Background:
- Frontotemporal lobar degeneration (FTLD) is typically classified by tau or TDP-43 protein aggregates.
- Approximately 10% of FTLD cases have uncertain molecular origins.
Purpose of the Study:
- To review genetic, clinical, and pathological features of tau/TDP-43 negative FTLD subtypes.
- To present recent advances in understanding the molecular basis of these rare FTLD disorders.
Main Methods:
- Literature review of genetic, clinical, and pathological studies.
- Focus on recent discoveries in tau/TDP-43 negative FTLD.
Main Results:
- Identification of FTLD-FUS subgroup characterized by fused in sarcoma (FUS) protein pathology.
- Clarification of functional consequences of pathogenic CHMP2B mutations.
Conclusions:
- Advances in understanding rare FTLD subtypes are expanding classification.
- New molecular subgroups like FTLD-FUS are being defined, improving diagnostic and research avenues.
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