Deficits in verbal fluency in presymptomatic C9orf72 mutation gene carriers: a developmental disorder

Background A mutation in C9orf72 constitute a cross-link between amyotrophic lateral sclerosis (ALS) and fronto-temporal dementia (FTD). At clinical manifestation, both patient groups may present with either cognitive impairment of predominantly behaviour or language (in FTD) or motor dysfunctions (...

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Hauptverfasser: Lulé, Dorothée (VerfasserIn) , Müller, Hans-Peter (VerfasserIn) , Finsel, Julia (VerfasserIn) , Weydt, Patrick (VerfasserIn) , Knehr, Antje (VerfasserIn) , Winroth, Ivar (VerfasserIn) , Andersen, Peter (VerfasserIn) , Weishaupt, Jochen H. (VerfasserIn) , Uttner, Ingo (VerfasserIn) , Kassubek, Jan Rainer (VerfasserIn) , Ludolph, Albert C. (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 27 August 2020
In: Journal of neurology, neurosurgery, and psychiatry
Year: 2020, Jahrgang: 91, Heft: 11, Pages: 1195-1200
ISSN:1468-330X
DOI:10.1136/jnnp-2020-323671
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1136/jnnp-2020-323671
Verlag, lizenzpflichtig, Volltext: https://jnnp.bmj.com/content/91/11/1195
Volltext
Verfasserangaben:Dorothée E Lulé, Hans-Peter Müller, Julia Finsel, Patrick Weydt, Antje Knehr, Ivar Winroth, Peter Andersen, Jochen Weishaupt, Ingo Uttner, Jan Kassubek, Albert C Ludolph

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520 |a Background A mutation in C9orf72 constitute a cross-link between amyotrophic lateral sclerosis (ALS) and fronto-temporal dementia (FTD). At clinical manifestation, both patient groups may present with either cognitive impairment of predominantly behaviour or language (in FTD) or motor dysfunctions (in ALS). - Methods In total, 36 non-symptomatic mutation carriers from ALS or FTD families were examined, including 21 subjects with C9orf72 and 15 with SOD1 mutations. Data were compared with 91 age-matched, education-matched and gender-matched healthy subjects (56 were first-degree relatives from ALS or FTD families, 35 with no known family history of ALS/FTD). MRI scanning for diffusion tensor imaging was performed to map fractional anisotropy (FA). Subjects performed an extensive neuropsychological assessment to address verbal fluency, language, executive, memory and visuospatial function. Measurements were repeated after 12 months. - Results C9orf72 expansion carriers performed significantly worse in verbal fluency and non-verbal memory and presented with distinct alterations in structural white matter integrity indicated by lower FA values in inferior and orbitofrontal cortical areas compared with carriers of SOD1 mutations or healthy subjects. Loss of structural integrity was associated with decreased verbal fluency performance. White matter alterations and cognitive performance showed no changes over 12 months in all subjects. - Discussion Reduced verbal fluency performance seems to be a distinct clinical feature of C9orf72 carriers before symptomatic disease onset without evidence for change over time in our cohort. The results support the emerging hypothesis of a general disorder in development in addition to neurodegeneration in C9orf72 carriers. 
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