A Hexanucleotide Repeat Expansion in C9ORF72 Is the Cause of Chromosome 9p21-Linked ALS-FTD

  • Alan E. Renton ,
  • Elisa Majounie ,
  • Adrian Waite ,
  • Javier Simon-Sanchez ,
  • Sara Rollinson ,
  • J. Raphael Gibbs ,
  • Jennifer C Scymick ,
  • Hannu Laaksovirta ,
  • John. C. van Swieten ,
  • Liisa Myllykangas ,
  • Hannu Kalimo ,
  • Anders Paetau ,
  • Yevgeniya Abramzon ,
  • Anne M. Remes ,
  • Alice Kaganovich ,
  • Sonja W. Scholz ,
  • Jamie Duckworth ,
  • Jinhui Ding ,
  • Daniel W. Harmer ,
  • Dena G. Hernandez ,
  • Janel O. Johnson ,
  • Kin Mok ,
  • Mina Ryten ,
  • Danyah Trabzuni ,
  • Rita J. Guerreiro ,
  • Richard W. Orrell ,
  • James Neal ,
  • Alex Murray ,
  • Justin Pearson ,
  • Iris E. Jansen ,
  • David Sondervan ,
  • Harro Seelaar ,
  • Derek Blake ,
  • Kate Young ,
  • Nicola Halliwell ,
  • Janis Bennion Callister ,
  • Greg Toulson ,
  • Anna Richardson ,
  • Alex Gerhard ,
  • Julie Snowden ,
  • David Mann ,
  • David Neary ,
  • Michael A. Nalls ,
  • Terhi Peuralinna ,
  • Lilja Jansson ,
  • Veli-Matti Isovaiita ,
  • Anna-Lotta Kaivorinne ,
  • Maarit Holtta-Vuori ,
  • Elina Ikonen ,
  • Raimo Sulkava ,
  • MIchael Benatar ,
  • Joanne Wuu ,
  • Adriano Chio ,
  • Garbiella Restagno ,
  • Giuseppe Borghero ,
  • Mario Sabatelli ,
  • The ITALSGEN Consortium ,
  • ,
  • Ekaterina ROgaeva ,
  • Lorne Zinman ,
  • Jeffrey D. Rothstein ,
  • MIchael Sendtner ,
  • Carsten Drepper ,
  • Evan E. Eichler ,
  • Can Alkan ,
  • Ziedulla Abdullaev ,
  • Svetlana D. Pack ,
  • Amalia Dutra ,
  • Evengenia Pak ,
  • John Hardy ,
  • Andrew SIngleton ,
  • Nigel M. Williams ,
  • Peter Heutink ,
  • Stuart Pickering-Brown ,
  • Huw R. Morris ,
  • Pentti J. Tienari ,
  • Bryan J. Traynor

Neuron | , Vol 72(2): pp. 257-268

Publication

The chromosome 9p21 amyotrophic lateral sclerosis-frontotemporal dementia (ALS-FTD) locus contains one of the last major unidentified autosomal-dominant genes underlying these common neurodegenerative diseases. We have previously shown that a founder haplotype, covering the MOBKL2b, IFNK, and C9ORF72 genes, is present in the majority of cases linked to this region. Here we show that there is a large hexanucleotide (GGGGCC) repeat expansion in the first intron of C9ORF72 on the affected haplotype. This repeat expansion segregates perfectly with disease in the Finnish population, underlying 46.0% of familial ALS and 21.1% of sporadic ALS in that population. Taken together with the D90A SOD1 mutation, 87% of familial ALS in Finland is now explained by a simple monogenic cause. The repeat expansion is also present in one-third of familial ALS cases of outbred European descent, making it the most common genetic cause of these fatal neurodegenerative diseases identified to date.