Genetic screening in early-onset dementia patients with unclear phenotype: relevance for clinical diagnosis.

Abstract:

:In a prospective study of dementia in Flanders (Belgium), we observed a substantial fraction of early-onset dementia patients who did not fulfill the criteria for a specific dementia subtype, leaving the patients without a precise clinical diagnosis. We selected 211 of these patients for genetic testing of causal genes linked to neurodegenerative brain diseases. In this group, the onset or inclusion age was 59.9 ± 8.2 years and 27.4% had a positive family history. We used a panel of 16 major genes linked to Alzheimer's disease, frontotemporal dementia, amyotrophic lateral sclerosis, Parkinson's disease, and prion diseases. In addition, we tested for the presence of a pathogenic C9orf72 repeat expansion. We identified 13 rare variants in 15 patients, including a carrier of variants in 2 different genes. Six patients (2.84%), carried a mutation in a Mendelian causal gene, that is, APP, MAPT, SOD1, TBK1, and C9orf72. In the other 7 patients, 7 variants were of uncertain significance, including a frameshift mutation in PSEN2, p.G359Lfs*74, in 2 patients sharing a common haplotype, and in LRRK2, p.L2063fs*. Expression studies showed reduced PSEN2 and a near complete loss of LRRK2, in lymphoblast cells or brain material of these patients. Overall, our study underscores the relevance of genetic testing of known causal genes in early-onset patients with symptomatology of neurodegenerative dementia but an unclear clinical diagnosis. A positive genetic result can help to obtain a precise diagnosis as well as a better understanding of the presence of multiple affected relatives in the family.

journal_name

Neurobiol Aging

journal_title

Neurobiology of aging

authors

Perrone F,Cacace R,Van Mossevelde S,Van den Bossche T,De Deyn PP,Cras P,Engelborghs S,van der Zee J,Van Broeckhoven C

doi

10.1016/j.neurobiolaging.2018.04.015

subject

Has Abstract

pub_date

2018-09-01 00:00:00

pages

292.e7-292.e14

eissn

0197-4580

issn

1558-1497

pii

S0197-4580(18)30149-0

journal_volume

69

pub_type

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