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C9ORF72 repeat expansions in cases with previously identified pathogenic mutations
Marka van Blitterswijk1, Matthew C Baker, Mariely DeJesus-Hernandez
1From the Departments of Neuroscience (M.v.B., M.C.B., M.D.-H., M.E.M., N.J.R., P.E.B., T.R., B.M., P.E.A.A., K.F.B., L.P., D.W.D., R.R.) and Neurology (Z.K.W., K.B.B., N.R.G.-R.), Mayo Clinic, Jacksonville, FL; Proteomics Unit and NeuroBioGen Lab-Memory Clinic (R.G., L.B., G.B.), IRCCS Istituto Centro San Giovanni di Dio-Fatebenefratelli, Brescia, Italy; Department of Clinical Neurological Sciences (E.F., M.J.S.), Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Canada; Division of Neurology (G.-Y.R.H.), and Department of Pathology and Laboratory Medicine (I.R.M.), University of British Columbia, Vancouver, Canada; Department of Neurology (B.J.K., D.S.K., R.C.P., B.F.B.), Mayo Clinic, Rochester, MN; Department of Pathology and Alzheimer's Disease Center (K.J.H., C.L.W.), University of Texas Southwestern Medical Center, Dallas; Department of Neurology (A.K., B.L.M.), University of California, San Francisco; Center for Neurodegenerative Disease Research (E.M.W., V.M.V.D.), Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia; Department of Neurology (G.C., D.H.G.), The David Geffen School of Medicine at University of California, Los Angeles; Cognitive Neurology & Alzheimer Disease Center (E.H.B., M.M.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Neurology (C.L.), Drexel University College of Medicine, Philadelphia, PA; Molecular Brain Research Group (M.J.S.), Robarts Research Institute, London, Canada; Banner Sun Health Research Institute (T.G.B.), Sun City, AZ; Cognitive Neuroscience Section (E.D.H.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; Departments of Psychiatry and Neurology (E.D.H.), Columbia University, New York; and Department of Neurology (T.B.), University of Washington School of Medicine, Seattle.
Co-occurring mutations in C9ORF72 and other neurodegenerative disease genes like GRN or MAPT can explain varied patient symptoms. This highlights the need to consider multiple genetic factors in C9ORF72 repeat expansion disorders.
Area of Science:
- Neurogenetics
- Molecular Biology
- Neuropathology
Background:
- Phenotypic variability in C9ORF72 repeat expansion disorders complicates diagnosis and treatment.
- Identifying genetic modifiers is crucial for understanding disease heterogeneity.
Purpose of the Study:
- To investigate the frequency of C9ORF72 repeat expansions in patients with known neurodegenerative disease gene mutations.
- To explore the role of co-occurring mutations in C9ORF72 expansion phenotypes.
Main Methods:
- A cohort of 334 subjects with known neurodegenerative disease mutations was screened for C9ORF72 expansions using fluorescent and repeat-primed PCR.
- Southern blotting and immunohistochemistry were employed for detailed analysis of a double mutant case.
Main Results:
- C9ORF72 repeat expansions were found in 1.2% of subjects, all exhibiting behavioral phenotypes.
- These individuals also carried pathogenic mutations in GRN or MAPT genes.
- Neuropathological analysis of a double mutant revealed mixed features characteristic of both C9ORF72 and GRN mutations.
Conclusions:
- The co-occurrence of C9ORF72 repeat expansions with other pathogenic mutations contributes to the diverse clinical presentations observed.
- These findings emphasize the importance of considering compound heterozygosity in C9ORF72-associated neurodegenerative diseases.
- Genetic counseling should account for this phenomenon when advising patients and families.
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