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Somatic Mosaicism in Amyotrophic Lateral Sclerosis and Frontotemporal Dementia

The study was designed to investigate the role of somatic mosaic mutations in the pathogenesis of sporadic amyotrophic lateral sclerosis (sALS) and frontotemporal dementia (sFTD). A panel of molecular inversion probes (MIP) were used to target the exons and exon-intron junctions of 88 neurodegeneration-related genes. The panel included 34 ALS/FTD genes, 10 Alzheimer's disease genes, 28 Parkinson's disease genes, and 16 genes associated with other rare neurodegenerative disorders. The panel was used to perform ultra-deep sequencing on postmortem brain and spinal cord from 404 individuals with sALS or sFTD and 144 age-matched neurotypical controls. Known pathogenic germline mutations were found in 20.6% of ALS cases and 26.5% of FTD cases. Predicted pathogenic somatic mutations were observed in 2.7% of sALS and sFTD cases that did not have known germline mutations. The somatic variants had low variant allele fraction and region-specific enrichment, particularly in the primary motor cortex of sALS cases and prefrontal cortex of sFTD cases.