Small striatal huntingtin inclusions in patients with motor neuron disease with reduced penetrance and intermediate HTT gene expansions Show others and affiliations
2024 (English) In: Human Molecular Genetics, ISSN 0964-6906, E-ISSN 1460-2083, Vol. 33, no 22, p. 1966-1974Article in journal (Refereed) Published
Abstract [en]
Short tandem repeat expansions in the human genome are overrepresented in a variety of neurological disorders. It was recently shown that huntingtin (HTT) repeat expansions with full penetrance, i.e. 40 or more CAG repeats, which normally cause Huntington's disease (HD), are overrepresented in patients with amyotrophic lateral sclerosis (ALS). Whether patients carrying HTT repeat expansions with reduced penetrance, (36-39 CAG repeats), or alleles with intermediate penetrance, (27-35 CAG repeats), have an increased risk of ALS has not yet been investigated. Here, we examined the role of HTT repeat expansions in a motor neuron disease (MND) cohort, searched for expanded HTT alleles, and investigated correlations with phenotype and neuropathology. MND patients harboring C9ORF72 hexanucleotide repeat expansions (HREs) were included, to investigate whether HTT repeat expansions were more common in this group. We found a high prevalence of intermediate (range 5.63%-6.61%) and reduced penetrance (range 0.57%-0.66%) HTT gene expansions in this cohort compared to other populations of European ancestry, but no differences between the MND cohort and the control cohort were observed, regardless of C9ORF72HRE status. Upon autopsy of three patients with intermediate or reduced penetrance HTT alleles, huntingtin inclusions were observed in the caudate nucleus and frontal lobe, but no significant somatic mosaicism was detected in different parts of the nervous system. Thus, we demonstrate, for the first time, huntingtin inclusions in individuals with MND and intermediate and reduced penetrance HTT repeat expansions but more clinicopathological investigations are needed to further understand the impact of HTT gene expansion-related pleiotropy.
Place, publisher, year, edition, pages Oxford University Press, 2024. Vol. 33, no 22, p. 1966-1974
Keywords [en]
C9ORF72HRE, Amyotrophic lateral sclerosis, huntingtin inclusions, somatic mosaicism
National Category
Neurosciences Medical Genetics and Genomics
Identifiers URN: urn:nbn:se:umu:diva-232510 DOI: 10.1093/hmg/ddae137 ISI: 001311874700001 PubMedID: 39270726 Scopus ID: 2-s2.0-85208854699 OAI: oai:DiVA.org:umu-232510 DiVA, id: diva2:1917394
Funder The Swedish Brain Foundation, FO 2022–0309 The Swedish Brain Foundation, FO2023–0088 Swedish Research Council, 2012–3167 Swedish Research Council, 2017–03100 Region Jämtland Härjedalen, JLL-980693 Knut and Alice Wallenberg Foundation, 2012.0091 Knut and Alice Wallenberg Foundation, 2014.0305 Knut and Alice Wallenberg Foundation, 2020.0232 Swedish Association of Persons with Neurological Disabilities Ulla-Carin Lindquist Foundation for ALS-Research, 2023.16 Västerbotten County Council, RV-993493 Västerbotten County Council, RV-996140 Västerbotten County Council, RV-939329 Västerbotten County Council, RV56103–7002829 Västerbotten County Council, RV-941598 Konung Gustaf V:s och Drottning Victorias Frimurarestiftelse 2024-12-022024-12-022025-03-25 Bibliographically approved