Brain imaging and neuropsychology in late-onset dementia due to a novel mutation (R93C) of valosin-containing protein.
Inclusion body myopathy with Paget disease of bone and frontotemporal dementia (IBMPFD, MIM 167320) is a recently identified autosomal dominant disorder due to mutations in the valosin-containing protein (VCP) that affects muscle, bone and brain. Brain involvement and neuropsychological findings of IBMPFD have not been described in detail. A patient carried a novel heterozygous base pair change, 47832C>T, in the VCP gene that resulted in substitution of an arginine residue by cysteine at position 93 (R93C). He presented first with myopathy while bone involvement remained subclinical. The patient developed behavioral abnormalities in his 60s and showed frank personality change with fluent empty speech at the age of 74 years. This syndrome was best classified as semantic dementia. Magnetic resonance imaging disclosed slight but progressive cerebral atrophy with prominent callosal and frontal white matter loss. Positron emission tomography demonstrated glucose hypometabolism of the frontal and temporal lobes disproportionate to their structural involvement. This first comprehensive clinical and neuroimaging study in IBMPFD may raise the awareness among clinicians as well as basic scientists for this exemplary genetic model of dementia.
Krause
S
S
Neurologische Klinik, Ludwig-Maximilians-Universität München, Germany.
Göhringer
T
T
Walter
M C
MC
Schoser
B G H
BG
Reilich
P
P
Linn
J
J
Pöpperl
G E
GE
Frölich
L
L
Hentschel
F
F
Lochmüller
H
H
Danek
A
A
D000251:Adenosine Triphosphatases / Q000235:genetics*; D000368:Aged; D001921:Brain / Q000473:pathology*; D018797:Cell Cycle Proteins / Q000235:genetics*; D004252:DNA Mutational Analysis; D003704:Dementia / Q000235:genetics* / Q000473:pathology* / Q000503:physiopathology; D020022:Genetic Predisposition to Disease; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D018482:Muscle, Skeletal / Q000473:pathology; D009154:Mutation; D018979:Myositis, Inclusion Body / Q000235:genetics / Q000473:pathology / Q000503:physiopathology; D019636:Neurodegenerative Diseases / Q000235:genetics* / Q000473:pathology* / Q000503:physiopathology; D009483:Neuropsychological Tests; D010001:Osteitis Deformans / Q000235:genetics / Q000473:pathology / Q000503:physiopathology; D016133:Polymerase Chain Reaction; D049268:Positron-Emission Tomography; D000074405:Valosin Containing Protein
D018797:Cell Cycle Proteins; D000251:Adenosine Triphosphatases; C000614178:VCP protein, human; D000074405:Valosin Containing Protein