Rare and common GBA variants are risk factors for both Parkinson's disease (PD) and dementia with Lewy bodies (DLB). However, the degree to which GBA variants are associated with neuropathological features in Lewy body disease (LBD) is unknown. Herein, we assessed 943 LBD cases and examined associations of 15 different neuropathological outcomes with common and rare GBA variants. Neuropathological outcomes included LBD subtype, presence of a high likelihood of clinical DLB (per consensus guidelines), LB counts in five cortical regions, tyrosine hydroxylase immunoreactivity in the dorsolateral and ventromedial putamen, ventrolateral substantia nigra neuronal loss, Braak neurofibrillary tangle (NFT) stage, Thal amyloid phase, phospho-ubiquitin (pS65-Ub) level, TDP-43 pathology, and vascular disease. Sequencing of GBA exons revealed a total of 42 different variants (4 common [MAFâ>â0.5%], 38 rare [MAFâ<â0.5%]) in our series, and 165 cases (17.5%) had a copy of the minor allele forââ¥â1 variant. In analysis of common variants, p.L483P was associated with a lower Braak NFT stage (ORâ=â0.10, Pâ<â0.001). In gene-burden analysis, presence of the minor allele for any GBA variant was associated with increased odds of a high likelihood of DLB (ORâ=â2.00, Pâ<â0.001), a lower Braak NFT stage (ORâ=â0.48, Pâ<â0.001), a lower Thal amyloid phase (ORâ=â0.55, Pâ<â0.001), and a lower pS65-Ub level (β: -0.37, Pâ<â0.001). Subgroup analysis revealed that GBA variants were most common in LBD cases with a combination of transitional/diffuse LBD and Braak NFT stage 0-II or Thal amyloid phase 0-1, and correspondingly that the aforementioned associations of GBA gene-burden with a decreased Braak NFT stage and Thal amyloid phase were observed only in transitional or diffuse LBD cases. Our results indicate that in LBD, GBA variants occur most frequently in cases with greater LB pathology and low AD pathology, further informing disease-risk associations of GBA in PD, PD dementia, and DLB.
Role of GBA variants in Lewy body disease neuropathology.
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作者:Walton Ronald L, Koga Shunsuke, Beasley Alexandra I, White Launia J, Griesacker Teresa, Murray Melissa E, Kasanuki Koji, Hou Xu, Fiesel Fabienne C, Springer Wolfdieter, Uitti Ryan J, Fields Julie A, Botha Hugo, Ramanan Vijay K, Kantarci Kejal, Lowe Val J, Jack Clifford R, Ertekin-Taner Nilufer, Savica Rodolfo, Graff-Radford Jonathan, Petersen Ronald C, Parisi Joseph E, Reichard R Ross, Graff-Radford Neill R, Ferman Tanis J, Boeve Bradley F, Wszolek Zbigniew K, Dickson Dennis W, Ross Owen A, Heckman Michael G
期刊: | Acta Neuropathologica | 影响因子: | 9.300 |
时间: | 2024 | 起止号: | 2024 Mar 12; 147(1):54 |
doi: | 10.1007/s00401-024-02699-w |
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