Frontotemporal Dementia and Chorea Associated with a Compound Heterozygous TREM2 Mutation

Article type: Research Article

Authors: Redaelli, Veronica^a | Salsano, Ettore^b | Colleoni, Lara^a | Corbetta, Paola^a | Tringali, Giovanni^c | Del Sole, Angelo^d | Giaccone, Giorgio^a | Rossi, Giacomina^{a; *}

Affiliations: [a] Unit of Neurology V and Neuropathology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy | [b] Unit of Neurodegenerative and Neurometabolic Rare Diseases, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy | [c] Unit of Neurosurgery III, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy | [d] Department of Diagnostic Services, Unit of Nuclear Medicine, ASST Santi Paolo e Carlo, Milan, Italy

Correspondence: [*] Correspondence to: Giacomina Rossi, PhD, Unit of Neurology V and Neuropathology, Fondazione IRCCS Istituto Neurologico Carlo Besta, via Amadeo 42, 20133 Milano, Italy. Tel.: +39 02 2394 4582; Fax: +39 02 2394 2101; E-mail: [email protected].

Abstract: Frontotemporal dementia (FTD) is clinically characterized by behavioral changes, language impairment, and executive dysfunction. FTD usually belongs to the frontotemporal lobar degeneration (FTLD) disease group, and its familial forms are dominantly inherited and linked to a group of genes relevant to frontal and temporal brain pathology, such as MAPT, GRN, C9ORF72, TARDBP, CHMP2B, VCP, and FUS. However, FTD can also be associated with different clinical or pathological phenotypes caused by mutations in other genes, whose heredity can be dominant or recessive. In this work we report on a familial case of FTD characterized by behavioral changes and aphasia, very early onset and very long duration, choreic movements, and white matter lesions at magnetic resonance imaging. We performed a wide-range genetic analysis, using a next generation sequencing approach, to evaluate a number of genes involved in neurodegeneration. We found a previously unreported compound heterozygous mutation in TREM2, that is commonly associated with the recessively inherited Nasu-Hakola disease. We discuss the differential diagnosis to be taken into account in cases of FTD presenting with atypical features.

Keywords: Chorea, differential diagnosis, frontotemporal dementia, genetic analysis, Nasu-Hakola disease, next generation sequencing, TREM2 , white matter

DOI: 10.3233/JAD-180018

Journal: Journal of Alzheimer's Disease, vol. 63, no. 1, pp. 195-201, 2018