A familial form of parkinsonism, dementia, and motor neuron disease: A longitudinal study

Shinsuke Fujioka, Bradley F. Boeve, Joseph E. Parisi, Pawel Tacik, Naoya Aoki, Audrey J. Strongosky, Matt Baker, Monica Sanchez-Contreras, Owen A. Ross, Rosa Rademakers, Vesna Sossi, Dennis W. Dickson, A. Jon Stoessl, Zbigniew K. Wszolek

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Objective: To describe the clinical, positron emission tomography (PET), pathological, and genetic findings of a large kindred with progressive neurodegenerative phenotypes in which the proband had autopsy-confirmed corticobasal degeneration (CBD). Methods: Five family members, including the proband, were examined neurologically. Clinical information from the other family members was collected by questionnaires. Three individuals underwent PET with 11C-dihydrotetrabenazine and 18F-fludeoxyglucose. The proband was examined post-mortem. Genetic studies were performed. Results: The pedigree contains 64 individuals, including 8 affected patients. The inheritance is likely autosomal dominant with reduced penetrance. The proband developed progressive speech and language difficulties at the age of 64 years. Upon examination at the age of 68 years, she showed non-fluent aphasia, word-finding difficulties, circumlocution, frontal release signs, and right-sided bradykinesia, rigidity, and pyramidal signs. She died 5 years after disease onset. The neuropathology was consistent with CBD, including many cortical and subcortical astrocytic plaques. Other family members had progressive neurodegenerative phenotypes - two were diagnosed with parkinsonism and behavioral problems, two with parkinsonism alone, one with amyotrophic lateral sclerosis alone, one with dementia, and one with progressive gait and speech problems. PET on three potentially affected individuals showed no significant pathology. Genetic sequencing of DNA from the proband excluded mutations in known neurodegenerative-related genes including MAPT, PGRN, LRRK2, and C9ORF72. Conclusions: Families with such complex phenotypes rarely occur. They are usually associated with MAPT mutations; however, in this family, MAPT mutations have been excluded, implicating another causative gene or genes. Further genetic studies on this family may eventually disclose the etiology.

Original languageEnglish (US)
Pages (from-to)1129-1134
Number of pages6
JournalParkinsonism and Related Disorders
Volume20
Issue number11
DOIs
StatePublished - Nov 1 2014

Keywords

  • Cognitive disorders
  • Corticobasal degeneration
  • Dementia
  • Genetics
  • PET
  • Parkinson's disease/Parkinsonism

ASJC Scopus subject areas

  • Neurology
  • Geriatrics and Gerontology
  • Clinical Neurology

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