Objective: To evaluate the frequency of c9ORF72 repeat expansion in french FTLD and FTLD-ALS patients and to describe the associated clinical phenotypes, imaging and brain pathological characteristics. Background c9ORF72 was recently identified as a major gene implicated in FTLD/ALS spectrum of disease. Its genetic contribution remains to be established in different geographic populations. Design/Methods: c9ORF72 repeat expansion was searched for by repeat-primed PCR in 600 french probands with frontal variant FTD (fvFTD, n=330), FTLD with amyotrophic lateral scelrosis (FTLD-ALS, n=210), primary progressive aphasia (PPA, n=40) and progressive supranuclear palsy (PSP, n=20). Half patients had a family history of FTLD or ALS, half were sporadic cases. Brain post-mortem examination was performed in 18 patients. Results: A GGGGCC repeat expansion was identified in 140 unrelated probands. The frequency of the expansion was 15% in the patients with bvFTD (8% in sporadic cases, 20% in familial bvFTD)and 43% in the patients with FTLD-ALS (15% in sporadic cases; 64% in familial forms). No expansion was identified in the PPA patients. Most patients had a bvFTD; only two patients presented with semantic dementia or progressive non fluent aphasia both associated with ALS at onset. The detailed clinical phenotypes, SPECT imaging characteristics and pathology of 60 c9ORF72 expansion carriers will be presented. Conclusions: c9ORF gene is the most frequent cause of familial FTLD before PGRN gene. The frequency of mutation is much higher in the population with FTLD-ALS. Less than 30% of familial FTLD/FTLD-ALS are unexplained by the eight known FTLD genes. Disclosure: Dr. Le Ber has nothing to disclose. Dr. Camuzat has nothing to disclose. Dr. Guillot-Noel has nothing to disclose. Dr. Guedj has nothing to disclose. Dr. Hannequin has nothing to disclose. Dr. Wargon has nothing to disclose. Dr. Couratier has nothing to disclose. Dr. Deramecourt has nothing to disclose. Dr. Berger has nothing to disclose. Dr. Viennet has nothing to disclose. Dr. Pasquier has nothing to disclose. Dr. Lacomblez Aurousseau has nothing to disclose. Dr. Salachas has nothing to disclose. Dr. Martinaud has nothing to disclose. Dr. Golfier has nothing to disclose. Dr. Puel has nothing to disclose. Dr. Vercelletto has nothing to disclose. Dr. Didic has nothing to disclose. Dr. Sauvee has nothing to disclose. Dr. Sellal has nothing to disclose. Dr. Thomas-Anterion has nothing to disclose. Dr. Campion has nothing to disclose. Dr. Michel has nothing to disclose. Dr. Dubois has received personal compensation for activities with Bristol-Myers Squibb, Roche, Elan, Eli Lilly, Eisai, and Janssen as a consultantDr. Dubois has received personal compensation for serving on the advisory board of Bristol-Myers Squibb, Roche, Elan, Eli Lilly, Eisai, and Janssen.Dr. Dubois has received research support from Novartis and Sanofi-Aventis. Dr. Camu has nothing to disclose. Dr. Seilhean has nothing to disclose. Dr. Meininger has received personal compensation for activities with Servier and GlaxoSmithKline. Dr. Habert has nothing to disclose. Dr. Duyckaerts has nothing to disclose. Dr. Brice has nothing to disclose.