Abstract

Clinical diagnosis of progressive supranuclear palsy (PSP) is sometimes difficult because various phenotypes have been identified. Here, we report a mutation in the bassoon (BSN) gene in a family with PSP-like syndrome. Their clinical features resembled not only those of PSP patients but also those of individuals with multiple system atrophy and Alzheimer’s disease. The neuropathological findings showed a novel three + four repeat tauopathy with pallido-luysio-nigral degeneration and hippocampal sclerosis. Whole-exome analysis of this family identified a novel missense mutation in BSN. Within the pedigree, the detected BSN mutation was found only in affected individuals. Further genetic analyses were conducted in probands from four other pedigrees with PSP-like syndrome and in 41 sporadic cases. Three missense mutations in BSN that are very rarely listed in databases of healthy subjects were found in four sporadic cases. Western blot analysis of tau following the overexpression of wild-type or mutated BSN revealed the possibility that wild-type BSN reduced tau accumulation, while mutated BSN lost this function. An association between BSN and neurological diseases has not been previously reported. Our results revealed that the neurodegenerative disorder associated with the original proband’s pedigree is a novel tauopathy, differing from known dementia and parkinsonism syndromes, including PSP.

Highlights

  • Clinical situation in each individual instead of labelling them with inaccurate diagnostic categories, e.g., atypical parkinsonism or PSP mimics[1]

  • With recent advances in genetics, new atypical parkinsonian conditions are emerging that share some clinical features with the classical phenotypes of PSP, corticobasal degeneration (CBD), and multiple system atrophy (MSA) and have been described as PSP, CBD, or MSA ‘look-alikes’[4]

  • All affected individuals were classified as having PSP-FTD12

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Summary

Introduction

Clinical situation in each individual instead of labelling them with inaccurate diagnostic categories, e.g., atypical parkinsonism or PSP mimics[1]. There are patients with an atypical four-repeat tauopathy who do not satisfy the pathological diagnostic criteria for corticobasal degeneration (CBD) or PSP, despite the presence of neurodegeneration with tau-positive neuronal and glial cytoplasmic inclusions[2,3]. With recent advances in genetics, new atypical parkinsonian conditions are emerging that share some clinical features with the classical phenotypes of PSP, CBD, and multiple system atrophy (MSA) and have been described as PSP, CBD, or MSA ‘look-alikes’[4]. PSP is usually sporadic, but a few pedigrees with familial clustering of PSP-like phenotypes have been described[5]. DCTN1 mutations should be screened for in patients showing clinical PSP-like phenotypes and behavioural variants of frontotemporal dementia (FTD)[9]. We present a novel pedigree that displays a PSP-like syndrome and harbours a mutation in bassoon (BSN), and we present our analysis of BSN mutations in four hereditary and 41 sporadic cases with PSP-like syndrome

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