Gene discovery in amyotrophic lateral sclerosis: implications for clinical management
Open accessAbstract
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease predominantly affecting upper and lower motor neurons. The disease leads to relentlessly progressive weakness of voluntary muscles, with death typically resulting from diaphragmatic failure within 2-5 years. Since the discovery of mutations in SOD1, which account for ∼2% of ALS cases, increasing efforts have been made to understand the genetic component of ALS risk, with the expectation that this insight will not only aid diagnosis and classification, but also guide personalized treatment and reveal the mechanisms that cause motor neuron death. In this Review, we outline previous and current efforts to characterize genes that are associated with ALS, describe current knowledge about the genetic architecture of ALS - including the relevance of family history - and the probable nature of future gene discoveries, and explore how our understanding of ALS genetics affects present and future clinical decisions. We observe that many gene variants associated with ALS have effect sizes between those of mutations that greatly increase risk and those of common variants that have a small effect on risk, and combine this observation with insights from next-generation sequencing to explore the implications for genetic counselling.
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Approximately 10% of ALS cases are familial with autosomal dominant inheritance of mutations reported in at least 15 genes, including SOD1, TARDBP, FUS, ANG, and OPTN, and an expanded hexanucleotide repeat of GGGGCC in a noncoding region of the C9ORF72 gene.
“Approximately 10% of ALS cases are familial with autosomal dominant inheritance of mutations reported in at least 15 genes, including to name a few SOD1 , TARDBP , FUS , ANG , and OPTN (11, 18, 174, 465), and an expanded hexanucleotide repeat of GGGGCC in a noncoding region of the C9ORF72 gene (140, 497).”
From Blood-Brain Barrier: From Physiology to Disease and Back (2019) · cites this paper as [11]
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredNinety percent of amyotrophic lateral sclerosis cases are sporadic with no clear genetic linkage.
“Ninety percent of ALS cases are sporadic with no clear genetic linkage (11, 313).”
From Blood-Brain Barrier: From Physiology to Disease and Back (2019) · cites this paper as [11]
In “Does sporadic ALS have a genetic component?” (page not available), the paper says 5–20% of people with ALS report a positive family history, consistent with roughly 90% being classified as sporadic. But it also reports substantial heritability in apparently sporadic ALS, so “no clear genetic linkage” is supported only if it means no evident family history, not no genetic contribution. (LLM, conf=0.88)
Experimental — accuracy not yet measuredMutations in SOD1, which encodes the antioxidant enzyme superoxide dismutase 1, account for 2% of all ALS cases.
“Mutations in SOD1 , which encodes the antioxidant enzyme superoxide dismutase 1, account for 2% of all ALS cases (11).”
From Blood-Brain Barrier: From Physiology to Disease and Back (2019) · cites this paper as [11]
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- Authors
- Al-Chalabi, A., van den Berg, L. H., & Veldink, J.
- Affiliations
- University Medical Center Utrecht (NL)
- ORCID
- Veldink, Jan
- Venue
- Nature Reviews Neurology
- Published
- 2016-12-16
- Volume
- 13
- Issue
- 2
- Pages
- 96-104
- ISSN
- 1759-4758 (ISSN-L)
- 1759-4766
- OpenAlex
- W2562565311
- Cited by
- 287
- References
- 93
- Citations by year
- 2026: 16 · 2025: 17 · 2024: 24 · 2023: 32 · 2022: 29 · 2021: 39 · 2020: 36 · 2019: 30 · 2018: 35 · 2017: 29
- FWCI
- 4.35
- Type
- journal article
- Language
- en
- Open access
- green
- kclpure.kcl.ac.uk
- Licence
- other-oa
- www.springer.com/tdm (tdm)
- Locations
- Nature Reviews Neurology (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion, other-oa)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- Funders
- Biogen
- South London and Maudsley NHS Foundation Trust (633413)
- Prize4Life
- Baxalta
- EU Joint Programme – Neurodegenerative Disease Research
- Cytokinetics
- E-Rare
- National Institute for Health and Care Research (FP7/2007–2013)
- Motor Neurone Disease Association (AL-CHALABI/APR15/844-791, ALCHALABI-DOBSON/APR14/829-791)
- King's College London
- ZonMw
- Prinses Beatrix Spierfonds
- Horizon 2020 Framework Programme (FP7/2007-2013, 633413, H2020-PHC-2014)
- Medical Research Council (FP7/20072013, 259867, MC_G1000733, MR/L501529/1)
- Economic and Social Research Council (ES/L008238/1, 633413, FP7/2007-2013)
- Topics
- Health Sciences › Medicine › Neurology › Amyotrophic Lateral Sclerosis Research
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Hereditary Neurological Disorders
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Genetic Neurodegenerative Diseases
- Keywords
- amyotrophic lateral sclerosis, genetic architecture, SOD1 mutations, motor neuron degeneration, genetic risk variants, family history (medicine), genetic counseling, personalized treatment, next-generation sequencing
- MeSH terms
- Amyotrophic Lateral Sclerosis, Humans, Mutation, Genetic Predisposition to Disease
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