Progranulin gene mutation with an unusual clinical and neuropathologic presentation

Christian Wider, Ryan J. Uitti, Zbigniew K. Wszolek, John Y. Fang, Keith A. Josephs, Matthew C. Baker, Rosa Rademakers, Michael L. Hutton, Dennis W. Dickson

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Progranulin gene (PGRN) mutations cause frontotemporal lobar degeneration with ubiquitin-positive inclusions (FTLD-U). Patients usually present with a frontotemporal dementia syndrome and have prominent atrophy and neuronal loss in frontal and temporal cortices and the striatum, with neuronal intranuclear and cytoplasmic inclusions. Clinical, neuropathological, and genetic studies are reported on an individual with PGRN mutation and her family members. We describe a patient with a PGRN c.26C>A mutation who presented with progressive stuttering dysarthria, oculomotor abnormalities, choreic buccolingual movements, and mild parkinsonism. Two other family members were affected, one with a behavioral variant frontotemporal dementia syndrome, the other with a diagnosis of probable Alzheimer's disease. At autopsy there was no neuronal loss in the cortex or medial temporal lobe structures, but there was striatal gliosis. Immunohistochemistry for ubiquitin and TDP-43 revealed neuronal cytoplasmic and intranuclear inclusions as well as neurites. This study further expands the clinical and pathological spectrum of PGRN mutations, and suggests the diagnosis could be missed in some individuals with atypical presentations.

Original languageEnglish (US)
Pages (from-to)1168-1173
Number of pages6
JournalMovement Disorders
Volume23
Issue number8
DOIs
StatePublished - Jun 15 2008

Keywords

  • Frontotemporal dementia
  • Neuropathology
  • Parkinson's disease/parkinsonism
  • Progranulin
  • Stuttering

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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