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Brain, Vol. 123, No. 12, 2467-2474, December 2000
© 2000 Oxford University Press

Pathology of early-onset Alzheimer's disease cases bearing the Thr113–114ins presenilin-1 mutation

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Andrew B. Singleton1,2,*, Ros Hall1,2, Clive G. Ballard1,2, Robert H. Perry2,3, John H. Xuereb4, David C. Rubinsztein5, Carolyn Tysoe5,{dagger}, Paul Matthews6, Barbara Cordell7, Samir Kumar-Singh8, Chris De Jonghe8, Marc Cruts8, Christine van Broeckhoven8 and Christopher M. Morris1,2

1 Medical Research Council Neurochemical Pathology Unit, 2 Institute for the Health of the Elderly and 3 Department of Neuropathology, Newcastle General Hospital, Newcastle upon Tyne, 4 Departments of Histopathology, and 5 Medical Genetics, Wellcome Trust Centre for the Study of Molecular Mechanisms of Disease, Cambridge Institute for Medical Research, Addenbrooke's Hospital, Cambridge, UK, 6 Nathan Kline Institute, New York, 7 Scios Nova Inc., Bayshore Mountain Parkway, Los Angeles, California, USA and 8 Department of Biochemistry, Flanders Interuniversity Institute for Biotechnology, Born-Bunge Foundation, University of Antwerp, Belgium

Correspondence to: Christopher M. Morris, Medical Research Council Neurochemical Pathology Unit, Newcastle General Hospital, Westgate Road, Newcastle upon Tyne NE4 6BE, UK E-mail: c.m.morris{at}ncl.ac.uk

Most cases of familial presenile Alzheimer's disease are caused by mutations in the presenilin-1 (PSEN-1) gene, most of these mutations being missense mutations. A mutation in the splice donor site of intron 4 of PSEN-1 has been described recently which results in aberrant splicing of PSEN-1 mRNA, causing insertion of an additional amino acid, Thr113–114ins, into the protein. We studied the neuropathology of four cases bearing this mutation in an attempt to clarify the pathology of this hereditary form of Alzheimer's disease and to determine whether it differs from other familial forms of the disease. The disease presented as a progressive cognitive decline, myoclonus and seizures developing later in the disease, a feature common to PSEN-1-linked Alzheimer's disease. The course of the disease was relatively rapid, death occurring approximately 6 years after onset. Pathology in the intron 4 cases demonstrated a severe Alzheimer's disease pathology with abundant deposition of ß-amyloid (Aß) 1–42 senile plaques and the formation of neurofibrillary tangles. Amyloid angiopathy was present in these cases and was readily demonstrated by Aß 1–40 staining, particularly in the cerebellum. Cases with the intron 4 mutation appear clinically and pathologically similar to other cases of early-onset Alzheimer's disease bearing PSEN-1 mutations.


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