Common mutations of interest in the diagnosis of amyotrophic lateral sclerosis: how common are common mutations in ALS genes?

Expert Rev Mol Diagn. 2020 Jul;20(7):703-714. doi: 10.1080/14737159.2020.1779060. Epub 2020 Jun 16.

Abstract

Introduction: Amyotrophic lateral sclerosis (ALS) is a complex neurodegenerative disease predominantly affecting upper and lower motor neurons. Diagnosis of this devastating pathology is very difficult because the high degree of clinical heterogeneity with which it occurs and until now, no truly effective treatment exists.

Areas covered: Molecular diagnosis may be a valuable tool for dissecting out ALS complex heterogeneity and for identifying new molecular mechanisms underlying the characteristic selective degeneration and death of motor neurons. To date, pathogenic variants in ALS genes are known to be present in up to 70% of familial and 10% of apparently sporadic ALS cases and can be associated with risks for ALS only or risks for other neurodegenerative diseases. This paper shows the procedure currently used in diagnostic laboratories to investigate most frequent mutations in ALS and evaluating the utility of involved molecular techniques as potential tools to discriminate 'common mutations' in ALS patients.

Expert opinion: Genetic testing may allow for establishing an accurate pathological diagnosis and a more precise stratification of patient groups in future drug trials.

Keywords: Amyotrophic lateral sclerosis; diagnosis; genes; genetic tests; mutations.

Publication types

  • Review

MeSH terms

  • Amyotrophic Lateral Sclerosis / diagnosis
  • Amyotrophic Lateral Sclerosis / ethnology
  • Amyotrophic Lateral Sclerosis / genetics*
  • C9orf72 Protein / genetics
  • DNA Mutational Analysis / methods
  • DNA Repeat Expansion
  • DNA-Binding Proteins / genetics
  • Ethnicity / genetics
  • Gene Frequency
  • Genetic Predisposition to Disease
  • High-Throughput Nucleotide Sequencing
  • Humans
  • Molecular Diagnostic Techniques
  • Mutation*
  • Mutation, Missense
  • Protein Aggregation, Pathological / genetics
  • RNA-Binding Protein FUS / genetics
  • Sequence Analysis, DNA / methods
  • Superoxide Dismutase-1 / genetics

Substances

  • C9orf72 Protein
  • C9orf72 protein, human
  • DNA-Binding Proteins
  • FUS protein, human
  • RNA-Binding Protein FUS
  • SOD1 protein, human
  • TARDBP protein, human
  • Superoxide Dismutase-1