Motor neuron involvement in multisystem proteinopathy

Implications for ALS

Michael G Benatar, Joanne Wuu, Catalina Fernandez, Conrad C. Weihl, Heather Katzen, Julie Steele, Bjorn Oskarsson, J. Paul Taylor

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

Objective: To explore the putative connection between inclusion body myopathy, Paget disease, frontotemporal dementia (IBMPFD) and motor neuron disease (MND). Methods: Clinical, genetic, and EMG characterization of 17 patients from 8 IBMPFD families. Results: Limb weakness was the most common clinical manifestation (present in 15 patients, median onset age 38 years, range 25-52), with unequivocal evidence of upper motor neuron dysfunction in 3. EMG, abnormal in all 17, was purely neurogenic in 4, purely myopathic in 6, and mixed neurogenic/myopathic in 7. Cognitive/behavioral impairment was detected in at least 8. Mutations in VCP (R155H, R159G, R155C) were identified in 6 families, and in hnRNPA2B1 (D290V) in another family. The genetic cause in the eighth family has not yet been identified. Conclusion: Mutations in at least 4 genes may cause IBMPFD, and its phenotypic spectrum extends beyond IBM, Paget disease, and frontotemporal dementia (FTD). Weakness, the most common and disabling manifestation, may be caused by muscle disease or MND. The acronym IBMPFD is, therefore, insufficient to describe disorders due to VCP mutations or other recently identified IBMPFD-associated genes. Instead, we favor the descriptor multisystem proteinopathy (MSP), which encompasses both the extended clinical phenotype and the previously described prominent pathologic feature of protein aggregation in affected tissues. The nomenclature MSP1, MSP2, and MSP3 may be used for VCP-, HNRNPA2B1-, and HNRNPAl-associated disease, respectively. Genetic defects in MSP implicate a range of biological mechanisms including RNA processing and protein homeostasis, both with potential relevance to the pathobiology of more common MNDs such as amyotrophic lateral sclerosis (ALS) and providing an additional link between ALS and FTD.

Original languageEnglish
Pages (from-to)1874-1880
Number of pages7
JournalNeurology
Volume80
Issue number20
DOIs
StatePublished - May 14 2013

Fingerprint

Amyotrophic Lateral Sclerosis
Motor Neurons
Frontotemporal Dementia
Inclusion Bodies
Muscular Diseases
Motor Neuron Disease
Mutation
Merozoite Surface Protein 1
Neuron
Age of Onset
Terminology
Genes
Proteins
Homeostasis
Extremities
RNA
Phenotype
Muscles
Inclusion

ASJC Scopus subject areas

  • Clinical Neurology
  • Arts and Humanities (miscellaneous)

Cite this

Benatar, M. G., Wuu, J., Fernandez, C., Weihl, C. C., Katzen, H., Steele, J., ... Taylor, J. P. (2013). Motor neuron involvement in multisystem proteinopathy: Implications for ALS. Neurology, 80(20), 1874-1880. https://doi.org/10.1212/WNL.0b013e3182929fc3

Motor neuron involvement in multisystem proteinopathy : Implications for ALS. / Benatar, Michael G; Wuu, Joanne; Fernandez, Catalina; Weihl, Conrad C.; Katzen, Heather; Steele, Julie; Oskarsson, Bjorn; Taylor, J. Paul.

In: Neurology, Vol. 80, No. 20, 14.05.2013, p. 1874-1880.

Research output: Contribution to journalArticle

Benatar, MG, Wuu, J, Fernandez, C, Weihl, CC, Katzen, H, Steele, J, Oskarsson, B & Taylor, JP 2013, 'Motor neuron involvement in multisystem proteinopathy: Implications for ALS', Neurology, vol. 80, no. 20, pp. 1874-1880. https://doi.org/10.1212/WNL.0b013e3182929fc3
Benatar, Michael G ; Wuu, Joanne ; Fernandez, Catalina ; Weihl, Conrad C. ; Katzen, Heather ; Steele, Julie ; Oskarsson, Bjorn ; Taylor, J. Paul. / Motor neuron involvement in multisystem proteinopathy : Implications for ALS. In: Neurology. 2013 ; Vol. 80, No. 20. pp. 1874-1880.
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