Abstract

Limbic‐predominant age‐related TAR‐DNA‐binding protein‐43 (TDP‐43) encephalopathy with hippocampal sclerosis pathology (LATE‐NC + HS) is a neurodegenerative disorder characterized by severe hippocampal CA1 neuron loss and TDP‐43‐pathology, leading to cognitive dysfunction and dementia. Polymorphisms in GRN, TMEM106B and ABCC9 are proposed as LATE‐NC + HS risk factors in brain bank collections. To replicate these results in independent population‐representative cohorts, hippocampal sections from brains donated to three such studies (Cambridge City over 75‐Cohort [CC75C], Cognitive Function and Ageing Study [CFAS], and Vantaa 85+ Study) were stained with hematoxylin–eosin (n = 744) and anti‐pTDP‐43 (n = 713), and evaluated for LATE‐NC + HS and TDP‐43 pathology. Single nucleotide polymorphism genotypes in GRN rs5848, TMEM106B rs1990622 and ABCC9 rs704178 were determined. LATE‐NC + HS (n = 58) was significantly associated with the GRN rs5848 genotype (χ2(2) = 20.61, P < 0.001) and T‐allele (χ2(1) = 21.04, P < 0.001), and TMEM106B rs1990622 genotype (Fisher's exact test, P < 0.001) and A‐allele (χ2(1) = 25.75, P < 0.001). No differences in ABCC9 rs704178 genotype or allele frequency were found between LATE‐NC + HS and non‐LATE‐NC + HS neuropathology cases. Dentate gyrus TDP‐43 pathology associated with GRN and TMEM106B variations, but the association with TMEM106B nullified when LATE‐NC + HS cases were excluded. Our results indicate that GRN and TMEM106B are associated with severe loss of CA1 neurons in the aging brain, while ABCC9 was not confirmed as a genetic risk factor for LATE‐NC + HS. The association between TMEM106B and LATE‐NC + HS may be independent of dentate TDP‐43 pathology.

Highlights

  • Hippocampal sclerosis in old age is a dementing disorder characterized by severe loss of pyramidal neurons and gliosis in the hippocampal CA1 area

  • Our results indicate that GRN and TMEM106B are associated with severe loss of CA1 neurons in the aging brain, while ABCC9 was not confirmed as a genetic risk factor for limbic-predominant age-related TDP-43 encephalopathy (LATE)-NC + HS

  • All hippocampal sclerosis cases in CC75C and Cognitive Function and Ageing Studies (CFAS) with available TAR-deoxyribonucleic acid (DNA)-binding protein-43 (TDP-43) staining (n = 22) were positive for hippocampal dentate neuronal cytoplasmic inclusions (NCI), while in the Vantaa 85+ cohort 26 of the 34 hippocampal sclerosis cases with TDP43-immunostained sections presented with dentate NCI

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Summary

Introduction

Hippocampal sclerosis in old age is a dementing disorder characterized by severe loss of pyramidal neurons and gliosis in the hippocampal CA1 area. In addition to the anatomically defined neuron loss, hippocampal sclerosis is frequently associated with aggregations of transactive response DNA binding protein 43kDa (TDP-43) (15). Hippocampal sclerosis in old age with TDP-43 pathology is a subgroup of LATE-NC (LATE-NC + HS). Putative risk alleles for LATE-NC+ HS from Finland, 79-100% LATE-NC + HS cases were found to have TDP-43 pathology in the hippocampal dentate gyrus (6, 10). The exact etiological pathophysiology of LATE-NC + HS is still unclear, but polymorphisms in the progranulin-encoding gene GRN (rs5848) (3), transmembrane protein 106B-encoding gene TMEM106B (rs1990622) (16), and sulfonylurea receptor 2-encoding ABCC9 (rs704178, in near-perfect linkage disequilibrium with rs704180) (14) have emerged as potential risk factors within US brain bank-based genome-wide association studies (GWAS)

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