Familial tauopathy with P364S MAPT mutation: clinical course, neuropathology and ultrastructure of neuronal tau inclusions.

Familial tauopathy with P364S MAPT mutation: clinical course, neuropathology and ultrastructure of neuronal tau inclusions.

Neuropathol Appl Neurobiol. 2017 Dec 07;:

Authors: Štrafela P, Pleško J, Magdič J, Koritnik B, Zupan A, Glavač D, Bresjanac M, Popović M

Abstract
AIMS: This report presents the clinical course, neuropathology and ultrastructure of neuronal tau inclusions of four Slovene relatives with P364S MAPT mutation.
METHODS: The clinical history of three out of four P364S MAPT mutation carriers was taken. After formalin fixation, thorough sampling of the central nervous system was followed by paraffin embedding, H&E, Gallyas, Bielschowsky, and immunostaining with AT8, anti-3R, anti-4R tau, anti-Amyloid-β, anti-TDP43, and anti-alpha-synuclein antibodies. The distribution and density of different types of neuronal tau inclusions were semi-quantitatively assessed. In addition, the ultrastructure of neuronal tau inclusions was analysed.
RESULTS: Macroscopic examination of the brains was unremarkable. Microscopically, neuronal tau inclusions of almost all known types were widespread and distributed fairly uniformly in all cases. Pick bodies and swollen neurons were found in only one family member. Mutant tau was composed of 3R and 4R isoforms, with a slight predominance of 3R tau. Composite neuronal tau inclusion (CNTI), found in all four relatives, was a hallmark of the P364S MAPT mutation. CNTI showed compartmental differences in H&E and Gallyas staining, tau isoforms immunolabelling and ultrastructure, displaying fuzzy fibrils in the core and paired twisted tubules at the periphery.
CONCLUSIONS: P364S MAPT mutation is characterized clinically by a variable combination of frontotemporal dementia, parkinsonism and motor neuron disease of short duration, and neuropathologically by a widespread uniform distribution of all known neuronal tau inclusions in one family member. Two-compartment CNTI is a unique characteristic of the P364S MAPT mutation. This article is protected by copyright. All rights reserved.

PMID: 29215752 [PubMed - as supplied by publisher]

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