Several lines of evidence suggest that the expression of the cellular prion protein (PrPC) is altered with age and in sporadic Alzheimer’s disease, however, published results have been contradictory. Furthermore, a relationship between the expression of PrPC and Tau has started to emerge. We have revealed a specific relationship between the expression of PrPC and Tau in neuroblastoma cell lines and transgenic mouse models. In addition, we identified that the expression levels of PrPC are reduced in multiple brain regions following the progression of sporadic Alzheimer’s disease. Furthermore, the reduction in PrPC expression significantly correlated with the reduction in Tau expression and coincided with an increase in Tau pathology. In addition, data from neuroblastoma cell lines implicated the glycosylphosphatidylinositol (GPI)-anchor and in part the localisation of PrPC to lipid rafts in mediating these alterations to Tau. We hypothesise that the reduction in PrPC expression reflects a primary mechanism in Alzheimer’s disease pathogenesis and indirectly triggers the reduction in Tau expression which subsequently contributes to neuronal destabilisation and disruption to neuronal function. Soluble oligomeric forms of amyloid-beta are the primary pathogenic species in Alzheimer’s disease and strongly correlate with the presence and severity of cognitive decline. PrPC acts as a high affinity neuronal receptor for amyloid-beta oligomers and triggers pathogenic signaling cascades which induce synaptic impairment and further exacerbate neuronal destabilisation. We demonstrated that Flotillin-1 and the lipid raft localisation of PrPC are essential for the binding of amyloid-beta oligomers to PrPC. Furthermore, the metabotropic glutamate receptor, mGluR5 plays a pivotal role in the aberrant signaling of PrPC, and this PrPC/mGluR5 complex provides a mechanistic link between extracellular amyloid-beta oligomers and intracellular Tau phosphorylation, by Fyn kinase, Pyk2 and possibly by inactivation of the protein phosphatase, PP2A. Considering there is now strong evidence that Tau is the mediator of amyloid-beta induced toxicity, the reduction in Tau levels mediated by PrPC may be a protective mechanism. amyloid-beta oligomers interact with a multitude of neuronal receptors in addition to PrPC. It is likely that activation of multiple receptor complexes and signalling cascades are responsible for synaptic impairment and Tau phosphorylation induced by amyloid-beta, however, these complexes remain to be fully determined. Investigating amyloid-beta oligomer induced Tau phosphorylation in vitro has proven challenging, however, we suggest that a functional, mature, neuronal model is necessary to induce the complex mechanisms linking extracellular amyloid-beta oligomers and the phosphorylation of intracellular Tau. A greater understanding of the complex relationship between amyloid-beta, PrPC and Tau will aid in our understanding of the molecular mechanisms underlying Alzheimer’s disease and in the discovery of novel therapeutic targets for this progressive neurodegenerative disease.

No description available.

Diss. (sammanfattning) Stockholm : Karol. inst., 2002. / Härtill 5 uppsatser.

Genome wide association studies (GWAS) have identified the H1 microtubule associated protein tau (MAPT) haplotype single nucleotide polymorphisms as leading common risk variants for Parkinson's disease (PD), progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD). Gene expression studies have demonstrated haplotype-specific increases in expression of MAPT exon 3-containing transcripts from the protective H2 allele compared to the H1. The difference in alternative splicing between the haplotypes likely contributes risk or protection in the absence of protein coding variants. Here, we investigate the regulation of MAPT exon 3 alternative splicing by common, risk-associated, non-coding, haplotype-specific single nucleotide polymorphisms (SNPs) through a combination of in silico analysis of the MAPT locus, in vitro gene expression and biochemistry studies. Comparative sequence analysis of whole-locus genomic H1 and H2 MAPT (143 kb) vectors showed they capture over 86% of the MAPT sequence diversity. We generated and expressed haplotype-hybrid H1 and H2 MAPT vectors in a human neuroblastoma cell culture model and demonstrated that a functional SNP rs17651213 near the exon 3 5' splice site regulates exon 3 inclusion in a haplotype-specific manner. Using RNA-electrophoretic mobility shift assays (RNA-EMSA), we showed differential RNA-protein complex formation at the H1 and H2 sequence variants of SNP rs17651213. We further identified candidate trans-acting splicing factors interacting with functional SNP rs17651213 sequences by RNA-protein pull-down experiment and mass spectrometry. Finally, gene knockdown of candidate splice factors identified by mass spectrometry demonstrated a role for hnRNP F and hnRNP Q in the haplotype-specific regulation of exon 3 inclusion. In this study, we have dissected the MAPT locus to identify sequences regulating the allele-specific alternative splicing of exon 3 and provided mechanistic insights into how common non-coding H1/H2 MAPT haplotype-specific SNPs may contribute to the risk/protection of neurodegeneration at a complex genetic locus.

Abstract Alzheimer's disease (AD) and frontotemporal lobar degeneration (FTLD) are the two most common neurodegenerative diseases leading to early onset dementia (< 65 years). Mutations in the amyloid precursor protein (APP), presenilin 1 (PSEN1) and presenilin 2 (PSEN2) genes cause a proportion of familial early-onset AD (eoAD), while the microtubule-associated protein tau (MAPT) and progranulin (PGRN) mutations have been identified in FTLD patients. Only a few PSEN1 and APP mutations have previously been found in Finnish AD patients, and one MAPT mutation in a FTLD family, while the role of PGRN in Finnish FTLD patients is unknown. Increasing evidence suggests that mitochondrial dysfunction and oxidative stress also play an important role in neurodegenerative diseases. The aim here was to investigate the genetics of eoAD and FTLD in the population of the province of Northern Ostrobothnia, Finland. Sequencing analysis of the APP, PSEN1 and PSEN2 genes was performed to determine whether mutations in these genes could be detected. The MAPT and PGRN genes were analysed in the FTLD patients by sequencing and MAPT haplotypes were determined. The contributions of mtDNA and its maintenance enzymes to eoAD and FTLD were studied by comparing the frequencies of mtDNA haplogroups and their clusters between the patient groups and controls and by screening for the five common POLG1 mutations (T251I, A467T, P587L, W748S, Y955C), two common mtDNA mutations (m.3243A>G, m.8344A>G) and mutations in the PEO1 and ANT1 genes. This is the first report of a significant association between the mtDNA haplogroup cluster IWX and FTLD. The H2 MAPT haplotype was also associated with FTLD in our cohort. No significant differences in the frequencies of the mtDNA haplogroups were observed between the eoAD patients and controls, nor were there any pathogenic mutations detected in the genes analysed. The findings suggest that possession of the mtDNA haplogroup cluster IWX and the H2 MAPT haplotype may be possible risk factors for FTLD in our cohort. The absence of any pathogenic mutations in the MAPT, PGRN, APP or PSEN genes in our series, together with the previous reports of only a few mutations found in this region, supports a minor role for these genes in the aetiology of eoAD and FTLD in Northern Ostrobothnia and indicates that this population may have its own genetic features. There may be other, still unknown genetic factors to be discovered, that explain familial diseases in the region.

Ce travail de cette thèse porte sur la dynamique des protéines, accompagnées de leur eau d'hydratation, une couche de solvant autour des protéines vitale pour leur fonction biologique. Chacune de ces deux composantes s'accompagne d'une dynamique qui lui est propre et dont la réunion reforme le paysage énergétique du système biologiquement actif. La mise en application conjointe de la deutération sélective, de la diffusion incohérente de neutrons ainsi que la spectroscopie terahertz a permis d'explorer de manière indépendante la dynamique des protéines et de celles des couches d'hydratation. L'influence de l'état de repliement de la protéine sur sa dynamique a été étudié par diffusion élastique de neutrons. Les protéines globulaires se sont montrées moins dynamiques que ses analogues intrinsèquement désordonnées. Eux même semblent être plus rigides que les protéines dépliées non physiologiques. L'état d'oligomérisation et les conséquences sur la dynamique de ces protéines ont été développés. Les agrégats d'une protéine globulaire se sont avérés être plus flexibles que la forme soluble. A l'inverse, les agrégats d'une protéine désordonnée voient leur dynamique moyenne baisser par rapport à la forme soluble. Ces observations témoignent de la grande diversité de dynamiques à travers le protéome. Les expériences de diffusion incohérente de neutrons sur les couches d'hydratation des protéines globulaires et désordonnées ont permis d'obtenir des informations sur la nature des mouvements de l'eau autour des protéines. Les mesures ont mis en évidence la présence de mouvements translationnels concomitants à l'apparition de la transition dynamique dans les couches d'hydratations, vers 220 K. Les mesures ont de même montré un couplage plus fort entre une protéine désordonnée et son eau d'hydratation que celui entre une protéine globulaire et son eau d'hydratation. La nature de la couche d'hydratation et son influence sur sa dynamique ont été explorés, avec l'utilisation de polymères qui miment le comportement de l'eau et agissent comme source de flexibilité pour la protéine. Pour terminer, la dynamique des groupements méthyles, impliqués dans les modifications dynamiques observées à 150 et 220 K, a été étudiée. / This thesis work focused on the dynamics of proteins, surrounded by their hydration layer, a water shell around the protein vital for its biological function. Each of these components is accompanied by a specific dynamics which union reforms the complex energy landscape of the system. The joint implementation of selective deuteration, incoherent neutron scattering and terahertz spectroscopy allowed to explore the dynamics of proteins and that of the hydration shell. The influence of the folding state of protein on its dynamics has been studied by elastic neutron scattering. Globular proteins were less dynamic than its intrinsically disordered analogues. Themselves appear to be stiffer than non physiological unfolded proteins. The oligomerization state and the consequences on the dynamics were investigated. Aggregates of a globular protein proved to be more flexible than the soluble form. In contrast, aggregates of a disordered protein showed lower average dynamics compared to the soluble form. These observations demonstrate the wide range of dynamics among the proteome. Incoherent neutron scattering experiences on the hydration layer of globular and disordered proteins have yielded information on the nature of water motion around these proteins. The measurements revealed the presence of translational motions concomitant with the onset of the transition dynamics of hydration layers, at 220 K. Measurements have also shown a stronger coupling between a disordered protein and its hydration water, compared to a globular protein and its hydration shell. The nature of the hydration layer and its influence on its dynamics has been explored with the use of polymers that mimic the water behavior and that act as a source of flexibility for the protein. Eventually, the dynamics of methyl groups involved in the dynamical changes observed at 150 and 220 K, was investigated.

Les tauopathies sont des maladies neurodégénératives caractérisées par l’agrégation intracérébrale de protéines tau anormales. Cependant ces maladies sont très hétérogènes sur le plan clinique, anatomopathologique mais aussi biochimique avec l'agrégation de différentes isoformes de protéines tau. De nombreux axes de recherche existent à ce jour afin de mieux comprendre ces maladies incurables. Au cours de cette thèse d'université, nous avons étudié les modifications de l’épigénome qui constituent une piste nouvelle et très prometteuse dans la recherche sur les maladies neurodégénératives. L'épigénétique est un processus dynamique et réversible qui peut être modifié par de nombreux facteurs génétiques ou environnementaux et qui joue un rôle très important dans la régulation des gènes. De nombreuses études rapportent une association entre certaines marques épigénétiques et les maladies neurodégénératives. Par exemple, dans la maladie d’Alzheimer, il a été observé une hyperméthylation de l'ADN, au niveau du promoteur du gène MAPT qui code les protéines tau.Dans ce contexte, nos objectifs étaient de déterminer si des variations de l'épigénome impliquant le gène MAPT contribuent à l'expression différentielle des protéines tau qui est observée dans les différentes classes de tauopathies. Nous avons donc constitué et caractérisé une banque de prélèvements cérébraux de témoins et de patients atteints de différentes tauopathies. Puis nous avons analysé la méthylation de l'ADN dans 3 tauopathies : la maladie d'Alzheimer, la paralysie supranucléaire progressive et la DCB. Notre étude a permis de mettre en évidence chez les patients atteints de PSP une hypométhylation dans l’inton 0 du gène MAPT. Cette hypométhylation ne concernait que le cortex frontal, affecté par la pathologie tau, mais pas le cortex occipital qui est épargné par la pathologie tau. De plus, nous avons également mis en évidence dans le tissu cérébral des patients atteints de PSP une hyperexpression des ARNm de MAPT par rapport aux témoins. Nous démontrons avec ce travail que l’hypométhylation de l'ADN de l’intron 0 de MAPT constitue une signature épigénétique spécifique de la PSP. Cette première étude nous a conduits à suspecter l'existence d'un promoteur alternatif du gène MAPT situé dans cette région de l'intron 0. Nous avons donc testé in vitro l'activité de ce promoteur et cloné des transcrits issu de ce promoteur alternatif. Nous avons ensuite confirmé ces analyses par la mesure de l'expression des ARNm par qPCR. Au total, ces expériences prouvent l'existence et la fonctionnalité de ce promoteur alternatif dans le cerveau humain. De plus, l'activation de ce promoteur alternatif aboutit à la transcription d'ARNm plus courts codant pour de nouvelles protéines tau qui pourraient être impliquées dans la survenue des tauopathies. / Tauopathies are neurodegenerative diseases characterized by intracerebral aggregation of abnormal tau proteins. However, these diseases are heterogeneous clinically, pathologically but also biochemically with the aggregation of different isoforms of tau protein. Many lines of research exist to date to better understand these incurable diseases. During this university thesis, we studied the changes in the epigenome that constitute a new and very promising approach in research on neurodegenerative diseases. Epigenetics is a dynamic and reversible process which can be modified by numerous genetic or environmental factors and plays a very important role in gene regulation. Many studies report an association between some epigenetic marks and neurodegenerative diseases. For example, in Alzheimer\'s disease, it has been observed hypermethylation of DNA in the promoter of the MAPT gene which encodes the tau protein.In this context, our objective was to determine if changes in epigenomic involving MAPT gene contribute to the differential expression of tau protein which is observed in the different classes of tauopathies. So we have established and characterized a human brainbank of controls and patients with different tauopathies. Then we analyzed the DNA methylation in 3 tauopathies: Alzheimer\'s disease, progressive supranuclear palsy, and CBD. Our study highlighted in PSP patients hypomethylation in intron 0 of MAPT gene. This hypomethylation concerned only the frontal cortex, affected by the tau-pathology but not the occipital cortex which is spared by tau-pathology. In addition, we also shown in the brain tissue of patients with PSP an overexpression of mRNA of MAPT compared to controls. We demonstrate in this work that hypomethylation of DNA in intron 0 of MAPT is a specific epigenetic signature of PSP. This first study has led us to suspect the existence of an alternative promoter of the MAPT gene located in this region of intron 0. We tested the in vitro activity of this promoter and cloned transcripts derived from this alternative promoter. We then confirmed this analysis by measuring mRNA expression by qPCR. In total, these experiments prove the existence and the functionality of this alternative promoter in the human brain. Furthermore, activation of the alternative promoter results in shorter mRNA transcripts encoding novel tau proteins that might be involved in the onset of the tauopathies.

Aggregation of microtubule-associated protein tau is involved in the pathology of several neurodegenerative diseases, including Alzheimer’s disease. The affibody TP4 has been shown to inhibit this aggregation process, and its target-binding positions were previously grafted onto a dimeric affibody scaffold, creating the sequestrin seqTP4. This project constitutes a part of the affinity maturation process of seqTP4, using two different bacterial display methods. An error-prone PCR library was first expressed on Staphylococcus carnosus cells for selection of variants with improved tau-binding properties, resulting in a library of 1.4×107 transformants. Flow cytometric tests indicated difficulties in the setup due to nonspecific interactions, and whereas several different approaches to alleviate the problems were investigated, two cell sorting attempts were ultimately unsuccessful. Subcloning of seqTP4 and the library to an Escherichia coli surface display vector resulted in functional surface expression of seqTP4 on E. coli JK321 and BL21 cells, and a BL21 library size of 1.6×109 transformants. An initial flow cytometric test of this library indicates the presence of improved tau-binding variants, paving the way for future cell sorting. / Aggregering av mikrotubuli-associerat protein tau är involverad i patologin av flera neurodegenerativa sjukdomar, däribland Alzheimers sjukdom. Affibodymolekylen TP4 har visat sig inhibera denna aggregeringsprocess, och överföring av dess målbindande positioner till ett dimeriskt affibodyprotein har tidigare gett upphov till seqTP4, en så kallad sequestrin. Detta projekt utgör ett led i processen att affinitetsmaturera seqTP4, med hjälp av två olika metoder för presentation av proteiner på ytan av bakterieceller. Ett error-prone PCR-bibliotek uttrycktes först på ytan av Staphylococcus carnosus-celler för selektion av varianter med ökad affinitet för tau, vilket resulterade i ett bibliotek av 1.4×107 transformanter. Flödescytometriska tester tydde på svårigheter i detta upplägg på grund av ospecifika interaktioner, och emedan flera olika angreppssätt för att förmildra dessa problem undersöktes, misslyckades slutligen två cellsorteringsförsök. Omkloning av seqTP4 och biblioteket till en vektor för ytpresentation på Escherichia coli resulterade i funktionellt ytuttryck av seqTP4 på E. coli JK321- och BL21-celler, och ett BL21-bibliotek bestående av 1.6×109 transformanter. Ett första flödescytometriskt test av detta bibliotek tyder på närvaron av varianter med förbättrad förmåga att binda tau, och vägen ligger nu relativt öppen för cellsortering.

Près de 40% des protéines présentes dans les cellules sont prédites partiellement ou complètement désordonnées. Ces protéines dépourvues de structure tridimensionnelle à l'état natif sont impliquées dans de nombreux mécanismes biologiques, la flexibilité jouant un rôle moteur dans les mécanismes de reconnaissance moléculaire. La prise en considération de l'existence de flexibilité au sein des protéines et des interactions protéines-protéines a nécessité le renouvellement de nos connaissances, de notre appréhension des fonctions biologiques ainsi que des approches pour étudier et interpréter ces phénomènes. La méthode retenue pour étudier ces transitions conformationnelles est la spectroscopie par résonance magnétique nucléaire. Elle dispose d'une sensibilité unique, d'une résolution à l'échelle atomique et permet par diverses expériences d'accéder à l'ensemble des échelles de temps définissant les mouvements de ces protéines. Nous combinons ces mesures expérimentales à un modèle statistique représentant l'ensemble du paysage énergétique des protéines désordonnées : la description par ensemble explicite de structures. Ce modèle est une représentation discrète des différents états échantillonnés par ces protéines. Il permet, combinant les déplacements chimiques, les couplages dipolaires et la relaxation paramagnétique, de développer une description moléculaire de l'état déplié en caractérisant à la fois l'information locale et l'information à longue portée présente dans les protéines intrinsèquement désordonnées. / Around 40% of the human genome does not fold into stable three-dimensional structures but are either unfolded, or contain unfolded regions of significant length. The inherent flexibility of this class of proteins is essential for their function in a vast range of biomolecular process such as molecular recognition. In order to take into account the specificity of these interactions, it has been necessary to invent new approaches to study and interpret their behaviour. Nuclear magnetic resonance spectroscopy is a unique atomic resolution probe which is sensitive to a very large range of time scales. We combine experimental NMR data with a statistical model describing the energy landscape of unfolded state : the explicit ensemble description. This model is a discrete representation of the different states of theses proteins. Combining chemical shifts, residual dipolar couplings and paramagnetic relaxation enhancement, it is then possible to develop a molecular description of the unfolded state caracterising both the local and long-range information of intrinsically disordered proteins.

Abstract Frontotemporal lobar degeneration (FTLD) is the second most common neurodegenerative disease leading to early-onset dementia (< 65 years), next to Alzheimer’s disease. FTLD is substantially a genetic disorder with up to 50% of cases having a positive family history. Mutations in the genes microtubule-associated protein tau (MAPT) and progranulin (PGRN) account for about 10–20% of all cases of FTLD. Hexanucleotide repeat expansion mutation within the gene C9ORF72 has recently been identified as the major cause of FTLD, FTLD with amyotrophic lateral sclerosis (ALS) and pure ALS. During this study, hexanucleotide repeat expansion within the C9ORF72 gene was shown to explain nearly 50% of familial and 30% of all FTLD cases in the Finnish population. Otherwise, the genetic background of Finnish FTLD is largely unknown. The object of the present work was to disentangle the genetic aetiology of FTLD in the Finnish population. We studied a cohort of patients with a clinical diagnosis of FTLD from the province of Northern Ostrobothnia, Finland. Sequencing analysis of the genes MAPT, charged multi-vesicular body protein 2B (CHMP2B) and TAR DNA binding protein (TARDBP) were performed and the MAPT haplotypes were analysed. Correlations between genotype and phenotype were studied in patients with C9ORF72 repeat expansion mutation. C9ORF72 expansion mutation explained nearly 30% of cases of FTLD in our cohort. Concomitant ALS and positive family history of the disease increased the possibility of carrying expanded C9ORF72. The clinical phenotype of C9ORF72 expansion carriers varied at presentation: both behavioural and language variants were detected with or without ALS. The behavioural presentations included prominent psychotic features, although psychiatric presentations were not overrepresented in expansion carriers. No pathogenic mutations were identified in the MAPT, CHMP2B and TARDBP genes in our series of FTLD patients. The H2 MAPT haplotype was associated with FTLD in the series. Our findings emphasise the importance of C9ORF72 expansion mutation in FTLD. While mutations in MAPT and PGRN cause a significant proportion of cases of FTLD worldwide, they seem to be rare causes of FTLD in the Finnish population. Besides being infrequent in other populations, mutations in CHMP2B and TARDBP are rare causes of FTLD in the Finnish population as well. Our findings have clinical implications for recognising phenotypic features characteristic of expanded C9ORF72 as well as for genetic counselling of Finnish patients with FTLD. Even though a considerable proportion of our cases of familial FTLD is caused by the C9ORF72 expansion, over 50 % of our familial cases are without a molecular genetic diagnosis, suggesting that there are other unidentified causal genes to be found. / Tiivistelmä Otsa-ohimolohkorappeumat on toiseksi yleisin työikäisten dementiaa aiheuttava etenevä aivojen rappeumasairaus. Toisinaan otsa-ohimolohkorappeumat esiintyvät yhdessä liikehermorappeuman, amyotrofisen lateraaliskleroosin (ALS), kanssa. Perinnöllisillä tekijöillä on todennäköisesti keskeinen merkitys taudin taustalla. Mutaatiot microtubule-associated protein tau (MAPT)- ja progranulin (PGRN) geeneissä aiheuttavat yhteensä 10–20 % otsa-ohimolohkorappeumista maailmalla. C9ORF72-geenissä sijaitsevan toistojaksomonistuman on vastikään todettu olevan yleisin otsa-ohimolohkorappeumia ja ALS:a aiheuttava mutaatio. Mutaatio on erityisen yleinen suomalaisessa väestössä selittäen lähes 50 % suvuittaisista ja 30 % kaikista otsa-ohimolohkorappeumista. Oireyhtymän perinnöllisyys on muutoin huonosti tunnettu suomalaisessa väestössä. Tutkimuksen tavoitteena oli selvittää otsa-ohimolohkorappeumien geneettisiä syitä aineistossa, joka koostui vuosina 1999–2010 Oulun yliopistollisessa sairaalassa tutkituista potilaista. Tutkimuksessa selvitettiin MAPT-, charged multi-vesicular body protein 2B (CHMP2B)- ja TAR DNA-binding protein (TARDBP) geenien mutaatioiden esiintyvyyttä ja määritettiin MAPT-geenin haplotyypit. Lisäksi tutkittiin taudin kliinisiä erityispiirteitä C9ORF72-mutaation kantajilla. C9ORF72-mutaatio selitti lähes 30 % otsa-ohimolohkorappeumista aineistossamme. Tutkimuksessa havaittiin, että suvuittain esiintyvä tautimuoto ja ALS yhdistyneenä otsa-ohimolohkorappeumaan liittyivät merkittävästi C9ORF72-mutaatioon. Monistuman kantajien fenotyyppi oli moninainen – ensioireina oli sekä käytösongelmia että kielellisiä vaikeuksia. Vaikka C9ORF72-mutaation kantajilla on kuvattu runsaasti psykoottisia oireita, psykoottiset oireet eivät olleet selvästi yliedustettuna mutaation kantajilla aineistossamme. Tutkimuksessa ei löydetty tautia aiheuttavia mutaatioita MAPT-, CHMP2B- tai TARDBP-geeneistä. Havaitsimme kuitenkin tilastollisesti merkittävän yhteyden MAPT-geenin H2-haplotyypin ja otsa-ohimolohkorappeumien välillä. Tuloksemme antavat uutta tietoa C9ORF72-mutaation kantajien kliinisistä erityispiirteistä. MAPT-geenin mutaatioiden merkitys otsa-ohimolohkorappeumien synnyssä ei näyttäisi olevan suomalaisessa väestössä niin merkittävä kuin muissa väestöissä. CHMP2B- ja TARDBP-mutaatiot ovat harvinainen oireyhtymän syy myös suomalaisessa väestössä. Tuloksiamme voidaan hyödyntää suomalaisten otsa-ohimolohkorappeumapotilaiden perinnöllisessä neuvonnassa. Huomattavista edistysaskelista huolimatta yli puolet suvuittain esiintyvistä tautitapauksistamme on vailla geneettistä diagnoosia, mikä antaa aihetta jatkotutkimuksille.