Objective: To assess the frequency and clinical characteristics of patients with mutations of major amyotrophic lateral sclerosis (ALS) genes in a prospectively ascertained, population-based epidemiologic series of cases.
Methods:The study population includes all ALS cases diagnosed in Piemonte, Italy, from January 2007 to June 2011. Mutations of SOD1, TARDBP, ANG, FUS, OPTN, and C9ORF72 have been assessed.
Results:Out of the 475 patients included in the study, 51 (10.7%) carried a mutation of an ALS-related gene (C9ORF72, 32; SOD1, 10; TARDBP, 7; FUS, 1; OPTN, 1; ANG, none). A positive family history for ALS or frontotemporal dementia (FTD) was found in 46 (9.7%) patients. Thirty-one (67.4%) of the 46 familial cases and 20 (4.7%) of the 429 sporadic cases had a genetic mutation. According to logistic regression modeling, besides a positive family history for ALS or FTD, the chance to carry a genetic mutation was related to the presence of comorbid FTD (odds ratio 3.5; p ϭ 0.001), and age at onset Յ54 years (odds ratio 1.79; p ϭ 0.012).
Conclusions:We have found that ϳ11% of patients with ALS carry a genetic mutation, with Amyotrophic lateral sclerosis (ALS) is a degenerative disorder of adult age involving the motor system, with a progressive and invariably fatal course. In 5% of cases it is considered to be genetically transmitted (familial ALS [fALS]) 1,2 while in the remaining cases it occurs sporadically in the population (sporadic ALS [sALS] Several studies have assessed the frequency of mutations of single genes, 11 but few studies have compared relative frequencies of SOD1, TARDBP, ANG, ; all these studies were based on tertiary center series of cases, and were consequently skewed toward a younger population of patients with a larger number of fALS 16 ; moreover, only one of them reported data on C9ORF72, which is now