GBA-associated parkinsonism and dementia: beyond α-synucleinopathies?

Eur J Neurol. 2016 Mar;23(3):520-6. doi: 10.1111/ene.12894. Epub 2015 Nov 9.

Abstract

Background and purpose: To date the role of GBA mutations beyond α-synucleinopathies in the parkinsonism-dementia spectrum is still unclear. The aim of the study was to screen for GBA mutations in progressive supranuclear palsy (PSP), corticobasal syndrome (CBS), primary progressive aphasia (PPA) and the behavioural variant of frontotemporal dementia (bvFTD).

Methods: In all, 303 patients with a clinical diagnosis of PSP (n = 157), CBS (n = 39), PPA (n = 35) and bvFTD (n = 72) and 587 neurologically healthy controls were screened for the most common GBA mutations.

Results: GBA mutations were detected in one healthy control and four patients with a clinical diagnosis of PSP (n = 1), probable CBS (n = 2) and PPA (n = 1, with concomitant C9orf72 expansion). Overall the prevalence of GBA mutations was low in non-α-synucleinopathies but significantly higher in the CBS subgroup compared to controls.

Conclusion: Although numbers are small, our findings indicate that the clinical phenotype of GBA-associated neurodegenerative disease is more heterogeneous than previously assumed, including phenotypes not usually associated with underlying α-synucleinopathies. This may be of relevance, once causal therapeutic strategies for GBA-associated neurodegenerative disease are developed.

Keywords: C9orf72 expansion; GBA; corticobasal syndrome; frontotemporal dementia; primary progressive aphasia; progressive supranuclear palsy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aphasia, Primary Progressive / genetics*
  • Aphasia, Primary Progressive / physiopathology
  • Basal Ganglia Diseases / genetics*
  • Basal Ganglia Diseases / physiopathology
  • Female
  • Frontotemporal Dementia / genetics*
  • Frontotemporal Dementia / physiopathology
  • Glucosylceramidase / genetics*
  • Humans
  • Male
  • Middle Aged
  • Mutation
  • Phenotype
  • Supranuclear Palsy, Progressive / genetics
  • Supranuclear Palsy, Progressive / physiopathology

Substances

  • Glucosylceramidase