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An Atypical Presentation of Upper Motor Neuron Predominant Juvenile Amyotrophic Lateral Sclerosis Associated with TARDBP Gene: A Case Report and Review of the Literature

Authors :
Daniel Sánchez-Tejerina
Juan Luis Restrepo-Vera
Eulalia Rovira-Moreno
Marta Codina-Sola
Arnau Llauradó
Javier Sotoca
Maria Salvado
Núria Raguer
Elena García-Arumí
Raúl Juntas-Morales
Institut Català de la Salut
[Sánchez-Tejerina D, Restrepo-Vera JL, Llauradó A, Sotoca J, Salvado M, Juntas-Morales R] European Reference Network on Rare Neuromuscular Diseases (ERN EURO-NMD), Vall d’Hebron Hospital Universitari, Barcelona, Spain. Servei de Neurologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Rovira-Moreno E, Codina-Sola M, García-Arumí E] Àrea de Genètica Clínica i Molecular, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. [Raguer N] Servei de Neurofisiologia Clínica, Vall d’Hebron Hospital Universitari, Barcelona, Spain
Vall d'Hebron Barcelona Hospital Campus
Source :
Scientia
Publication Year :
2022
Publisher :
MDPI, 2022.

Abstract

Juvenile amyotrophic lateral sclerosis; Predominant disorder Esclerosi lateral amiotròfica juvenil; Trastorn predominant Esclerosis lateral amiotrófica juvenil; Trastorno predominante Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that can rarely affect young individuals. Juvenile ALS (JALS) is defined for individuals with an onset of the disease before the age of 25. The contribution of genetics to ALS pathology is a field of growing interest. One of the differences between adult-onset ALS and JALS is their genetic background, with a higher contribution of genetic causes in JALS. We report a patient with JALS and a pathogenic variant in the TARDBP gene (c.1035C > G; p.Asn345Lys), previously reported only in adult-onset ALS, and with an atypical phenotype of marked upper motor neuron predominance. In addition, the proband presented an additional variant in the NEK1 gene, c.2961C > G (p.Phe987Leu), which is classified as a variant of unknown significance. Segregation studies showed a paternal origin of the TARDBP variant, while the variant in NEK1 was inherited from the mother. We hypothesize that the NEK1 variant acts as a disease modifier and suggests the possibility of a functional interaction between both genes in our case. This hypothesis could explain the peculiarities of the phenotype, penetrance, and the age of onset. This report highlights the heterogeneity of the phenotypic presentation of ALS associated with diverse pathogenic genetic variants.

Details

Language :
English
Database :
OpenAIRE
Journal :
Scientia
Accession number :
edsair.doi.dedup.....d81011a902254633a22699831b02311d