Review Article

Oligonucleotide-Based Therapy for FTD/ALS Caused by the C9orf72 Repeat Expansion: A Perspective

Table 1

Comparison of pathology, clinical features, and prevalence of distinct FTD and/or ALS causative genes.

PathologyClinical featurePrevalenceReferences
TDP-43 P62/ubiquitin Ubiquilin2 FUS SOD1 Tau

FTD/ALS C9orf72 ++ALS—weakness in limbs (50–70%), bulbar involvement, dementia, and psychosis. FTD—behavioural variant, psychiatric symptoms.60% hereditary ALS-FTD
Up to 21% sporadic ALS
7–10% sporadic FTD
[22, 2528]

FTD/ALS UBQLN2 ++++ALS—upper motor neuron with spasticity, bulbar and pseudobulbar dysfunction, lower motor neuron involvement not prominent, and dementia. FTD—behavioural variant.5 families[32, 33]

ALS FUS ++Lower motor neuron signs with limbs and bulbar distribution, and upper motor neuron signs are common. 4-5% familial ALS
0.5–0.7% sporadic ALS
[24, 29, 30, 34, 35]

ALS SOD1 ++Lower and upper motor neuron signs, bulbar onset is unusual, and weakness in limbs is asymmetric.12-13% familial ALS
1–3% sporadic ALS
[24, 36, 37]

ALS TARDBP ++Weakness in arms before legs, few patients with bulbar involvement, and upper motor neuron involvement with mild or absent spasticity.3–6% familial ALS
8 patients described sporadic ALS
[24, 38]

FTD tau (MAPT)+Behavioural variant, progressive nonfluent aphasia.Up to 50% of total FTD patients[3941]

FTD FUS ++Behavioural variant. <1% of total FTD patients[28, 41]

FTD-TDP
(GRN)
++Behavioural variant, semantic dementia, and progressive nonfluent aphasia.3–26% of total FTD patients[15, 36, 4144]