Title
Distinct clinical characteristics of **C9orf72** expansion carriers compared with **GRN, MAPT**, and nonmutation carriers in a Flanders-Belgian FTLD cohort Distinct clinical characteristics of **C9orf72** expansion carriers compared with **GRN, MAPT**, and nonmutation carriers in a Flanders-Belgian FTLD cohort
Author
Faculty/Department
Faculty of Sciences. Biology
Faculty of Medicine and Health Sciences
Faculty of Pharmaceutical, Biomedical and Veterinary Sciences . Biomedical Sciences
Publication type
article
Publication
Chicago, Ill. ,
Subject
Human medicine
Source (journal)
JAMA neurology / American Medical Association. - Chicago, Ill., 2013, currens
Volume/pages
70(2013) :3 , p. 365-373
ISSN
2168-6149
2168-6157
ISI
000316804400011
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
Affiliation
University of Antwerp
Abstract
Objective To characterize patients with frontotemporal lobar degeneration (FTLD) with a repeat expansion mutation in the gene C9orf72, and to determine whether there are differences in the clinical presentation compared with FTLD carriers of a mutation in GRN or MAPT or with patients with FTLD without mutation. Design Patient series. Setting Dementia clinics in Flanders, Belgium. Patients Two hundred seventy-five genetically and phenotypically thoroughly characterized patients with FTLD. Main Outcome Measures Clinical and demographic characteristics of 26 C9orf72 expansion carriers compared with patients with a GRN or MAPT mutation, as well as patients with familial and sporadic FTLD without mutation. Results C9orf72 expansion carriers developed FTLD at an early age (average, 55.3 years; range, 42-69 years), significantly earlier than in GRN mutation carriers or patients with FTLD without mutation. Mean survival (6.2 years; range, 1.5-17.0 years) was similar to other patient groups. Most developed behavioral variant frontotemporal dementia (85%), with disinhibited behavior as the prominent feature. Concomitant amyotrophic lateral sclerosis is a strong distinguishing feature for C9orf72 -associated FTLD. However, in most patients (73%), amyotrophic lateral sclerosis symptoms were absent. Compared with C9orf72 expansion carriers, nonfluent aphasia and limb apraxia were significantly more common in GRN mutation carriers. Conclusions C9orf72 -associated FTLD most often presents with early-onset behavioral variant frontotemporal dementia with disinhibition as the prominent feature, with or without amyotrophic lateral sclerosis. Based on the observed genotype-phenotype correlations between the different FTLD syndromes and different genetic causes, we propose a decision tree to guide clinical genetic testing in patients clinically diagnosed as having FTLD.
E-info
https://repository.uantwerpen.be/docman/iruaauth/042455/c770788c52f.pdf
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