Frontotemporal lobar degeneration with ubiquitinated tau-negative inclusions and additional alpha-synuclein pathology but also unusual cerebellar ubiquitinated p62-positive, TDP-43-negative inclusions

Neuropathology. 2009 Aug;29(4):466-71. doi: 10.1111/j.1440-1789.2008.00966.x. Epub 2008 Aug 18.

Abstract

Mutations in the progranulin (PGRN) gene on chromosome 17 have been shown to be responsible for one non-tauopathy subtype of familial frontotemporal lobar degeneration - frontotemporal lobar degeneration with ubiquitinated, tau-negative inclusions (FTLD-U). Such cases have pathological similarities to sporadic cases with neuronal inclusions positive for ubiquitin, the ubiquitin binding protein, p62 and the newly recognised protein TDP-43 but negative for hyperphosphorylated (HP) tau. There has been a recent report on two families with a novel progranulin mutation where the neuropathology showed not only TDP-43 neuronal positivity but separate tau and/or alpha-synuclein pathology. We describe an unusual case with some family history but no mutation in the progranulin gene. The pathological features were typical for FTLD-U but with additional significant alpha-synuclein pathology, and unusual ubiquitin-positive, p62-positive, TDP-43-negative inclusions in the cerebellum. This case may represent a further pathological phenotype for familial FTLD-U. It also highlights the need for further investigations on the ubiquitin binding protein p62 as a marker in FTLD-U. It is certainly possible that the presence or absence of these ubiquitinated p62-positive yet TDP-43-negative cerebellar inclusions may act as a useful correlative factor in the future.

Publication types

  • Case Reports

MeSH terms

  • Adaptor Proteins, Signal Transducing / biosynthesis
  • Adaptor Proteins, Signal Transducing / metabolism*
  • Aged
  • Cerebellum / metabolism
  • Cerebellum / pathology*
  • DNA-Binding Proteins* / analysis
  • Female
  • Frontotemporal Lobar Degeneration / metabolism
  • Frontotemporal Lobar Degeneration / pathology*
  • Humans
  • Inclusion Bodies / chemistry
  • Inclusion Bodies / pathology*
  • Male
  • Sequestosome-1 Protein
  • Ubiquitination*
  • alpha-Synuclein / analysis*
  • tau Proteins* / analysis

Substances

  • Adaptor Proteins, Signal Transducing
  • DNA-Binding Proteins
  • SQSTM1 protein, human
  • Sequestosome-1 Protein
  • alpha-Synuclein
  • tau Proteins