Abstract

PurposeInclusion-body myopathy, Paget's disease of bone and frontotemporal dementia is an adult-onset autosomal dominant illness (IBMPFD) caused by mutations in the valosin-containing protein (VCP) on chromosome 9p21.1-p12. The penetrance of the gene is 82% for myopathy, 49% for Paget's disease, but may be as low as 30% for frontotemporal dementia. Modifier genes could account for decreased frontotemporal dementia penetrance. In this study apolipoprotein-E (APOE) was evaluated for this role in IBMPFD families based on its known modifier effect in Alzheimer's disease. MethodsFrom a database of 231 members of 15 families, 174 had APOE genotype available for analysis. Logistic regressions on APOE genotype and frontotemporal dementia were performed, using appropriate covariates. Results and ConclusionFTD was associated with APOE 4 genotype (P = 0.0002), myopathy (P = 0.0006), and age (P = 0.01), but not microtubule associated protein tau (MAPT) H2 haplotype (P = 0.5) or gender (0.09) after adjustment for membership in pedigrees with at least one APOE 4 genotype. These data suggest a potential link between APOE 4 genotype and the specific form of frontotemporal dementia found in IBMPFD. The molecular basis of this link bears further investigation. We did not observe an association of frontotemporal dementia and H2 MAPT haplotype.

Highlights

  • Inclusion-body myopathy, Paget’s disease of bone and frontotemporal dementia is an adult-onset autosomal dominant illness (IBMPFD) caused by mutations in the valosin-containing protein (VCP) on chromosome 9p21.1-p12

  • We previously reported a novel adult-onset autosomal dominant genetic disorder characterized by the cardinal features frontotemporal dementia, Paget’s disease of bone, and inclusion body myopathy[1] (IBMPFD; OMIM #605382)

  • Even the oldest of the subjects was below 65 years, and the median age was well below that expected for Alzheimer’s disease (AD), supporting the validity of the frontotemporal dementia (FTD) diagnosis

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Summary

Introduction

Inclusion-body myopathy, Paget’s disease of bone and frontotemporal dementia is an adult-onset autosomal dominant illness (IBMPFD) caused by mutations in the valosin-containing protein (VCP) on chromosome 9p21.1-p12. Results and Conclusion: FTD was associated with APOE 4 genotype (P ϭ 0.0002), myopathy (P ϭ 0.0006), and age (P ϭ 0.01), but not microtubule associated protein tau (MAPT) H2 haplotype (P ϭ 0.5) or gender (0.09) after adjustment for membership in pedigrees with at least one APOE 4 genotype These data suggest a potential link between APOE 4 genotype and the specific form of frontotemporal dementia found in IBMPFD. We previously reported a novel adult-onset autosomal dominant genetic disorder characterized by the cardinal features frontotemporal dementia, Paget’s disease of bone, and inclusion body myopathy[1] (IBMPFD; OMIM #605382). The status of APOE in sporadic frontotemporal lobar degeneration and other subtypes remains controversial.[7,8,9,10] Microtubule associated protein tau (MAPT) haplotype was investigated because of its described modifier effect in frontotemporal lobar degeneration, and possibly in AD.[11,12,13,14]

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