Targeted sequencing panels in Italian ALS patients support different etiologies in the ALS/FTD continuum

J Neurol. 2021 Oct;268(10):3766-3776. doi: 10.1007/s00415-021-10521-w. Epub 2021 Mar 26.

Abstract

Background: 5-10% of amyotrophic lateral sclerosis (ALS) patients presented a positive family history (fALS). More than 30 genes have been identified in association with ALS/frontotemporal dementia (FTD) spectrum, with four major genes accounting for 60-70% of fALS. In this paper, we aimed to assess the contribution to the pathogenesis of major and rare ALS/FTD genes in ALS patients.

Methods: We analyzed ALS and ALS/FTD associated genes by direct sequencing or next-generation sequencing multigene panels in ALS patients.

Results: Genetic abnormalities in ALS major genes included repeated expansions of hexanucleotide in C9orf72 gene (7.3%), mutations in SOD1 (4.9%), FUS (2.1%), and TARDBP (2.4%), whereas variants in rare ALS/FTD genes affected 15.5% of subjects overall, most frequently involving SQSTM1 (3.4%), and CHMP2B (1.9%). We found clustering of variants in ALS major genes in patients with a family history for "pure" ALS, while ALS/FTD related genes mainly occurred in patients with a family history for other neurodegenerative diseases (dementia and/or parkinsonism).

Conclusions: Our data support the presence of two different genetic components underlying ALS pathogenesis, related to the presence of a family history for ALS or other neurodegenerative diseases. Thus, family history may help in optimizing the genetic screening protocol to be applied.

Keywords: Amyotrophic lateral sclerosis; Frontotemporal degeneration; Genetic heterogeneity; Mutation screening; Next generation sequencing.

MeSH terms

  • Amyotrophic Lateral Sclerosis* / genetics
  • DNA-Binding Proteins / genetics
  • Frontotemporal Dementia* / genetics
  • Humans
  • Italy
  • Mutation / genetics

Substances

  • DNA-Binding Proteins