Journal
ACTA NEUROPATHOLOGICA
Volume 121, Issue 2, Pages 207-218Publisher
SPRINGER
DOI: 10.1007/s00401-010-0764-0
Keywords
Frontotemporal dementia; Frontotemporal lobar degeneration; Fused in sarcoma; Atypical frontotemporal lobar degeneration with ubiquitinated inclusions; Neuronal intermediate filament inclusion disease; Basophilic inclusion body disease
Categories
Funding
- Canadian Institutes of Health Research [74580]
- Pacific Alzheimer Research Foundation
- German Federal Ministry of Education and Research [01GI0704]
- Stavros-Niarchos Foundation
- Synapsis Foundation
- German Brain Bank BrainNet
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Most cases of frontotemporal lobar degeneration (FTLD) are characterized by abnormal intracellular accumulation of either tau or TDP-43 protein. However, in similar to 10% of cases, composed of a heterogenous collection of uncommon disorders, the molecular basis remains to be uncertain. We recently discovered that the pathological changes in several tau/TDP-43-negative FTLD subtypes are immunoreactive (ir) for the fused in sarcoma (FUS) protein. In this study, we directly compared the pattern of FUS-ir pathology in cases of atypical FTLD-U (aFTLD-U, N = 10), neuronal intermediate filament inclusion disease (NIFID, N = 5) and basophilic inclusion body disease (BIBD, N = 8), to determine whether these are discrete entities or represent a pathological continuum. All cases had FUS-ir pathology in the cerebral neocortex, hippocampus and a similar wide range of subcortical regions. Although there was significant overlap, each group showed specific differences that distinguished them from the others. Cases of aFTLD-U consistently had less pathology in subcortical regions. In addition, the neuronal inclusions in aFTLD-U usually had a uniform, round shape, whereas NIFID and BIBD were characterized by a variety of inclusion morphologies. In all cases of aFTLD-U and NIFID, vermiform neuronal intranuclear inclusions (NII) were readily identified in the hippocampus and neocortex. In contrast, only two cases of BIBD had very rare NII in a single subcortical region. These findings support aFTLD-U, NIFID and BIBD as representing closely related, but distinct entities that share a common molecular pathogenesis. Although cases with overlapping pathology may exist, we recommend retaining the terms aFTLD-U, NIFID and BIBD for specific FTLD-FUS subtypes.
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