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Published on: July 29, 2016
TBK1-associated motor neuron disease with concomitant vacuolar myopathy: a case resembling a multisystem
Yasmine Sluyts1, Kristof Van Schil2, Tine Deconinck2
1Department of Neurology, Neuromuscular Reference Centre, Antwerp University Hospital, Antwerp, Belgium.
Abstract:
We present a 75-year-old patient with an amyotrophic lateral sclerosis (ALS)-myopathy overlap phenotype and a pathogenic variant in TBK1. The ALS-myopathy overlap phenotype was extensively documented clinically, with mixed myopathic and neurogenic findings on needle EMG, muscle MRI and muscle biopsies, with presence of rimmed vacuoles immunoreactive for P62 in particular. A concomitant presentation of motor neuron disease (MND) and myopathy is most notably associated with a very rare, inherited group of diseases, known as multisystem proteinopathies (MSPs). An increasing number of genes have already been linked to an MSP phenotype, of which VCP-related MSP is the most frequent. In this report we expand the spectrum of clinical presentations of TBK1-associated disease and describe pathophysiological similarities between TBK1- and VCP-related disease.
Insights
This study details a patient with amyotrophic lateral sclerosis (ALS)-myopathy overlap and a TBK1 gene variant. It expands understanding of TBK1-associated diseases and their similarities to VCP-related multisystem proteinopathies.
Area of Science:
- Neurology
- Genetics
- Pathology
Background:
- Amyotrophic lateral sclerosis (ALS) and myopathy can co-occur, a phenotype associated with rare inherited multisystem proteinopathies (MSPs).
- TBK1 gene variants are increasingly recognized in neurological disorders.
- VCP-related MSP is the most common form of multisystem proteinopathy.
Observation:
- A 75-year-old patient presented with an ALS-myopathy overlap phenotype.
- Clinical evaluation revealed mixed myopathic and neurogenic findings on EMG, muscle MRI, and biopsy, notably P62-immunoreactive rimmed vacuoles.
Findings:
- A pathogenic variant in the TBK1 gene was identified in the patient.
- This case expands the known clinical spectrum of TBK1-associated disease.
- Pathophysiological similarities were observed between TBK1- and VCP-related diseases.
Implications:
- Highlights TBK1 as a gene implicated in ALS-myopathy overlap syndromes.
- Suggests shared underlying mechanisms between different genetic forms of multisystem proteinopathies.
- Informs diagnostic approaches and potential therapeutic strategies for rare inherited neuromuscular disorders.
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