Abstract

Frontotemporal dementia (FTD) is a heterogeneous clinical disorder characterized by progressive abnormalities in behavior, executive functions, personality, language and/or motricity. A neuropathological subtype of FTD, frontotemporal lobar degeneration (FTLD)-FET, is characterized by protein aggregates consisting of the RNA-binding protein fused in sarcoma (FUS). The cause of FTLD-FET is not well understood and there is a lack of genetic evidence to aid in the investigation of mechanisms of the disease. The goal of this study was to identify genetic variants contributing to FTLD-FET and to investigate their effects on FUS pathology. We performed whole-exome sequencing on a 50-year-old FTLD patient with ubiquitin and FUS-positive neuronal inclusions and unaffected parents, and identified a de novo postzygotic nonsense variant in the NCDN gene encoding Neurochondrin (NCDN), NM_014284.3:c.1206G > A, p.(Trp402*). The variant was associated with a ~ 31% reduction in full-length protein levels in the patient’s brain, suggesting that this mutation leads to NCDN haploinsufficiency. We examined the effects of NCDN haploinsufficiency on FUS and found that depleting primary cortical neurons of NCDN causes a reduction in the total number of FUS-positive cytoplasmic granules. Moreover, we found that these granules were significantly larger and more highly enriched with FUS. We then examined the effects of a loss of FUS function on NCDN in neurons and found that depleting cells of FUS leads to a decrease in NCDN protein and mRNA levels. Our study identifies the NCDN protein as a likely contributor of FTLD-FET pathophysiology. Moreover, we provide evidence for a negative feedback loop of toxicity between NCDN and FUS, where loss of NCDN alters FUS cytoplasmic dynamics, which in turn has an impact on NCDN expression.

Highlights

  • Frontotemporal dementia (FTD) is a common form of dementia characterized by a progressive neuronal loss, primarily across the frontal and temporal lobes, leading to changes in executive functions, personality, abnormal behaviors and language impairments [43, 54]

  • FET refers to the family of proteins composed of fused in sarcoma (FUS) (Fused in Sarcoma), EWS (Ewing Sarcoma Breakpoint region 1), and TAF15 (TATA-binding protein-associated factor 15) proteins, which are the main components of the aggregates [74]

  • Identification of a de novo variant in the NCDN gene in a frontotemporal lobar degeneration (FTLD)‐FET patient We aimed to identify a genetic determinant of FTLDFET in a female patient (AH-11-02) with early-onset, sporadic behavioral variant of FTD

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Summary

Introduction

Frontotemporal dementia (FTD) is a common form of dementia characterized by a progressive neuronal loss, primarily across the frontal and temporal lobes, leading to changes in executive functions, personality, abnormal behaviors and language impairments [43, 54]. Subtypes of FTLD are further categorized based on the composition of major proteins found in insoluble cellular inclusions. The three main subtypes of FTLD are defined by the protein composition of these inclusions: FTLD-Tau, FTLD-TDP (TAR-DNA binding protein-43), and FTLD-FET [51]. FTLD-TDP and FTLD-FET are both characterized by Tau-negative, ubiquitin-positive deposits and differ by the actual proteins involved in these deposits. FET refers to the family of proteins composed of FUS (Fused in Sarcoma), EWS (Ewing Sarcoma Breakpoint region 1), and TAF15 (TATA-binding protein-associated factor 15) proteins, which are the main components of the aggregates [74]. FTLD-FET accounts for 5–10% of all FTLD cases and it is further subdivided into three subtypes: atypical-FTLD with ubiquitin-positive inclusions (aFTLD-U), basophilic inclusion body disease (BIBD), and neuronal intermediate filament inclusion body disease (NIFID) (for review, see reference [58])

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