Abstract

Frontotemporal Dementia (FTD) is a focal neurodegenerative disease, with a strong genetic background, that causes early onset dementia. The present knowledge about the risk loci and causative mutations of FTD mainly derives from genetic linkage analysis, studies of candidate genes, Genome-Wide Association Studies (GWAS) and Next-Generation Sequencing (NGS) applications. In this review, we report recent insights into the genetics of FTD, and, specifically, the results achieved thanks to GWAS and NGS approaches. Linkage studies of large FTD pedigrees have prompted the identification of causal mutations in different genes: mutations in C9orf72, MAPT, and GRN genes explain the large majority of cases with a high family history of the disease. In cases with a less clear inheritance, GWAS and NGS have contributed to further understand the genetic picture of FTD. GWAS identified several common genetic variants with a modest risk effect. Of interest, many of these variants are in genes belonging to the endo-lysosomal pathway, the immune response and neuronal survival. On the opposite, the NGS approach allowed the identification of rare variants with a strong risk effect. These variants were identified in known FTD-associated genes and again in genes involved in the endo-lysosomal pathway and in the immune response. Interestingly, both approaches demonstrated that several genes are associated to multiple neurodegenerative disorders including FTD. Thanks to these complementary approaches, the genetic picture of FTD is becoming more clear and novel key molecular processes are emerging. This will foster opportunities to move toward prevention and therapy for this incurable disease.

Highlights

  • Genetic understanding of neurodegenerative diseases has considerably increased over the years, favoring the identification of possible targets for new potential therapies.In this review, we report the most recent genetic insights regarding Frontotemporal Dementia (FTD), a focal neurodegenerative disease affecting the frontal and temporal lobes of the brain.New Horizons in FTD GeneticsFTD has a heterogeneous clinical presentation: behavioral abnormalities are prominent in the behavioral variant FTD (Rascovsky et al, 2011), while language disabilities characterize the Primary Progressive Aphasias (PPAs) (GornoTempini et al, 2011)

  • In sporadic FTD patients without a recognized genetic cause in the well-known FTD related genes (MAPT, GRN, and C9orf72), novel variants were identified in two dementia-related genes, the Colony stimulating factor 1 receptor (CSF1R) and the Mitochondrial alanyltRNA synthetase 2 (AARS2), suggesting new genes to be considered for a genetic FTD diagnosis

  • In Giannoccaro et al (2017), a panel of dementia-associated genes was explored in an Italian group of Amyotrophic lateral sclerosis (ALS)/FTD pedigrees by using a Targeted Sequencing (TS) approach: genetic variants in additional ALS and dementia-related genes were found in four pedigrees, including a rare variant in the Tyrosine kinase binding protein (TYROBP) gene

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Summary

Introduction

Genetic understanding of neurodegenerative diseases has considerably increased over the years, favoring the identification of possible targets for new potential therapies.In this review, we report the most recent genetic insights regarding Frontotemporal Dementia (FTD), a focal neurodegenerative disease affecting the frontal and temporal lobes of the brain.New Horizons in FTD GeneticsFTD has a heterogeneous clinical presentation: behavioral abnormalities are prominent in the behavioral variant FTD (bvFTD) (Rascovsky et al, 2011), while language disabilities characterize the Primary Progressive Aphasias (PPAs) (GornoTempini et al, 2011). Pottier replicated the previously reported TMEM106B association and identified a novel genome-wide significant locus at the GDNF family receptor alpha 2 (GFRA2) gene, which encodes for a neurotropic factor with a key role involved in neuron survival and differentiation (Pottier et al, 2018).

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