Over 30% of patients with amyotrophic lateral sclerosis (ALS) exhibit cognitive deficits indicative of frontotemporal dementia (FTD), suggesting a common pathogenesis for both diseases. Consistent with this hypothesis, neuronal and glial inclusions rich in TDP43, an essential RNA-binding protein, are found in the majority of those with ALS and FTD, and mutations in TDP43 and a related RNAbinding protein, FUS, cause familial ALS and FTD. TDP43 and FUS affect the splicing of thousands of transcripts, in some cases triggering nonsense-mediated mRNA decay (NMD), a highly conserved RNA degradation pathway. Here, we take advantage of a faithful primary neuronal model of ALS and FTD to investigate and characterize the role of human up-frameshift protein 1 (hUPF1), an RNA helicase and master regulator of NMD, in these disorders. We show that hUPF1 significantly protects mammalian neurons from both TDP43-and FUS-related toxicity. Expression of hUPF2, another essential component of NMD, also improves survival, whereas inhibiting NMD prevents rescue by hUPF1, suggesting that hUPF1 acts through NMD to enhance survival. These studies emphasize the importance of RNA metabolism in ALS and FTD, and identify a uniquely effective therapeutic strategy for these disorders.A myotrophic lateral sclerosis (ALS) is a progressive and lethal motor neuron disease that most often arises sporadically, but can be inherited in 10-15% of patients (1). Many of the genes implicated in familial ALS (fALS) encode RNA-binding proteins, including fused in sarcoma (FUS), transactive response element DNA/RNA-binding protein of 43 kDa (TDP43), and heteronuclear ribonuclear proteins (hnRNPs) (2), emphasizing RNA-based toxicity as a fundamental mechanism contributing to motor neuron degeneration in ALS.More than 40 different mutations in the TDP43 gene (TARDBP) have now been associated with fALS (3). Disease-associated mutations in TARDBP affect the turnover (4), amount (5), and subcellular localization of TDP43 (6, 7), in many cases resulting in cytoplasmic TDP43 inclusions. Affected neurons in sporadic ALS (sALS) exhibit identical inclusions containing wild-type (WT) TDP43 (8), and WT TDP43 accumulation causes neurodegeneration in cellular and animal models (6, 9, 10), providing a pathogenic link between fALS and sALS. FUS mutations have also been linked to fALS (11,12). Unlike TDP43, FUS-related pathology is limited to fALS due to FUS mutations (13). FUS and TDP43 bind largely nonoverlapping RNA targets (14), leading to the unexpected conclusion that, despite their homology and involvement in fALS, TDP43 and FUS have distinct roles in RNA metabolism.TDP43 regulates its own expression through a negative feedback loop (15), but the mechanism by which it does so remains unclear. Conflicting data suggest that TDP43 autoregulation involves nonsense-mediated decay (NMD) (16) or exosome-mediated degradation (15). Excess TDP43 enhances splicing in the TARDBP 3′UTR, potentially targeting the transcript for NMD, whereas deficiencies in human up-frameshift prote...