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Presenilin-1 Mutations Are a Cause of Primary Lateral Sclerosis-Like Syndrome

Abstract:
Background and PurposePrimary lateral sclerosis (PLS) is a progressive upper motor neuron (UMN) disorder. It is debated whether PLS is part of the amyotrophic lateral sclerosis (ALS) spectrum, or a syndrome encompassing different neurodegenerative diseases. Recently, new diagnostic criteria for PLS have been proposed. We describe four patients of two pedigrees, meeting definite PLS criteria and harboring two different mutations in presenilin 1 (PSEN1).MethodsPatients underwent neurological and neuropsychological examination, MRI, 18F-fluorodeoxyglucose positron emission tomography (FDG-PET), amyloid-related biomarkers, and next-generation sequencing (NGS) testing.ResultsFour patients, aged 25–45 years old, presented with a progressive UMN syndrome meeting clinical criteria of definite PLS. Cognitive symptoms and signs were mild or absent during the first year of the disease but appeared or progressed later in the disease course. Brain MRI showed microbleeds in two siblings, but iron-related hypointensities in the motor cortex were absent. Brain FDG-PET showed variable areas of hypometabolism, including the motor cortex and frontotemporal lobes. Amyloid deposition was confirmed with either cerebrospinal fluid (CSF) or imaging biomarkers. Two heterozygous likely pathogenic mutations in PSEN1 (p.Pro88Leu and p.Leu166Pro) were found in the NGS testing.ConclusionClinically defined PLS is a syndrome encompassing different neurodegenerative diseases. The NGS testing should be part of the diagnostic workup in patients with PLS, at least in those with red flags, such as early-onset, cognitive impairment, and/or family history of neurodegenerative diseases.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.3389/fnmol.2021.721047

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Role:
Author
ORCID:
0000-0002-3043-7938
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Role:
Author
ORCID:
0000-0003-0973-9146
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Institution:
University of Oxford
Role:
Author


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Funder identifier:
10.13039/501100004587
Grant:
PI19/01178
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Funder identifier:
10.13039/501100011596
Grant:
2018/135


Publisher:
Frontiers Media
Journal:
Frontiers in Molecular Neuroscience More from this journal
Volume:
14
Pages:
721047-721047
Article number:
721047
Publication date:
2021-08-30
DOI:
EISSN:
1662-5099
ISSN:
1662-5099


Language:
English
Keywords:
Pubs id:
1260414
Local pid:
pubs:1260414
Source identifiers:
W3197639243
Deposit date:
2026-04-24
ARK identifier:
This ORA record was generated from metadata provided by an external service. It has not been edited by the ORA Team.

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