Amyotrophic Lateral Sclerosis (ALS) is a fatal neurodegenerative disease characterized by the progressive loss of motor function. Pathological mechanisms and clinical measures vary extensively from patient to patient, creating a spectrum of disease phenotypes with a poorly understood influence on individual outcomes like disease duration. The inability to ascertain patient phenotype has hindered clinical trial design and the development of more personalized and effective therapeutics. Wholistic analytical methods (‘-omics’) have provided unprecedented molecular resolution into cellular and system level disease processes and offer a foundation to better understand ALS disease variability. Building off initiatives by the New York Genome Center ALS Consortium and Target ALS groups, the goal of this work was to stratify a large patient cohort utilizing a range of bioinformatic strategies and bulk tissue gene expression (transcriptomes) from the brain and spinal cord. Central Hypothesis: Variability in the onset and progression of ALS is partially captured by molecular subgroups (subtypes) with distinct gene expression profiles and implicated pathologies. Work presented in this dissertation addresses the following: (Chapter 2): The use of unsupervised clustering and gene enrichment methods for the identification and characterization of patient subtypes in the postmortem cortex and spinal cord. Results obtained from this Chapter establish three ALS subtypes, identify uniquely dysregulated pathways, and examine intra-patient concordance between regions of the central nervous system. (Chapter 3): Patient subtypes from Chapter 2 are considered in the context of clinical outcomes, leveraging multiple survival models and gene co-expression analyses. Results from this Chapter establish a weak association between ALS subtype and clinical outcomes including disease duration and age at symptom onset. (Chapter 4): Utilizing differential expression analysis, ‘marker’ genes are defined and leveraged with supervised classification (“machine learning”) methods to develop a suite of classifiers design to stratify patients by subtype. Results from this Chapter provide postmortem marker genes for two of the three ALS subtypes and offer a foundation for clinical stratification. Significance: Knowledge gained from this research provides a foundation to stratify patients in the clinic and prior to enrollment in clinical trials, offering a path toward improved therapies.

Alzheimer’s disease (AD) is characterized by the degeneration of cholinergic basal forebrain (CBF) neurons in the nucleus basalis of Meynert (nbM), which provides the majority of cholinergic input to the cortical mantle and together form the basocortical cholinergic system. Histone deacetylase (HDAC) dysregulation in the temporal lobe has been associated with neuronal degeneration during AD progression. However, whether HDAC alterations play a role in cortical and cortically-projecting cholinergic nbM neuronal degeneration during AD onset is unknown. In an effort to characterize alterations in the basocortical epigenome semi-quantitative western blotting and immunohistochemistry were utilized to evaluate HDAC and sirtuin (SIRT) levels in individuals that died with a premortem clinical diagnosis of no cognitive impairment (NCI), mild cognitive impairment (MCI), mild/moderate AD (mAD), or severe AD (sAD). In the frontal cortex, immunoblots revealed significant increases in HDAC1 and HDAC3 in MCI and mAD, followed by a decrease in sAD. Cortical HDAC2 levels remained stable across clinical groups. HDAC4 was significantly increased in prodromal and mild AD compared to aged cognitively normal controls. HDAC6 significantly increased during disease progression, while SIRT1 decreased in MCI, mAD, and sAD compared to controls. Basal forebrain levels of HDAC1, 3, 4, 6 and SIRT1 were stable across disease progression, while HDAC2 levels were significantly decreased in sAD. Quantitative immunohistochemistry was used to identify HDAC2 protein levels in individual cholinergic nbM nuclei immunoreactive for the early phosphorylated tau marker AT8, the late-stage apoptotic tau marker TauC3, and Thioflavin-S, a marker of mature neurofibrillary tangles (NFTs). HDAC2 nuclear immunoreactivity was reduced in individual cholinergic nbM neurons across disease stages, and was exacerbated in tangle-bearing cholinergic nbM neurons. HDAC2 nuclear reactivity correlated with multiple cognitive domains and with NFT formation. These findings identify global HDAC and SIRT alterations in the cortex while HDAC2 dysregulation contributes to cholinergic nbM neuronal dysfunction and NFT pathology during the progression of AD.

Exome sequencing was used to identify novel variants linked to amyotrophic lateral sclerosis (ALS), in a family without mutations in genes previously linked to ALS. A F115C mutation in the gene MATR3 was identified, and further examination of other ALS kindreds identified an additional three mutations in MATR3; S85C, P154S and T622A. Matrin 3 is an RNA/DNA binding protein as well as part of the nuclear matrix. Matrin 3 interacts with TDP-43, a protein that is both mutated in some forms of ALS, and found in pathological inclusions in most ALS patients. Matrin 3 pathology, including mislocalization and rare cytoplasmic inclusions, was identified in spinal cord tissue from a patient carrying a mutation in Matrin 3, as well as sporadic ALS patients. In an effort to determine the mechanism of Matrin 3 linked ALS, the protein interactome of wild-type and ALS-linked MATR3 mutations was examined. Immunoprecipitation followed by mass spectrometry experiments were performed using NSC-34 cells expressing human wild-type or mutant Matrin 3. Gene ontology analysis identified a novel role for Matrin 3 in mRNA transport centered on proteins in the TRanscription and EXport (TREX) complex, known to function in mRNA biogenesis and nuclear export. ALS-linked mutations in Matrin 3 led to its re-distribution within the nucleus, decreased co-localization with endogenous Matrin 3 and increased co-localization with specific TREX components. Expression of disease-causing Matrin 3 mutations led to nuclear mRNA export defects of both global mRNA and more specifically the mRNA of TDP-43 and FUS. Our findings identify ALS-causing mutations in the gene MATR3, as well as a potential pathogenic mechanism attributable to MATR3 mutations and further link cellular transport defects to ALS.

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease characterized by the deterioration of motor neurons. ALS affects about 1 in 20,000 people and leads to death within 2 to 5 years after diagnosis. There is currently no cure for ALS, but there are many genes known to be associated with ALS, such as SOD 1 and C9orf72. Recently, mutations in Matrin 3 were linked to ALS. While 15 mutations in Matrin 3 have been discovered, this study focuses on the four initial mutations, which are the Ser85Cys, Phe115Cys, Pro154Ser, and Thr622Ala mutations. This study attempts to understand the mechanism of how these mutations lead to ALS. The first aim focuses on the role of Matrin mutations in the mislocalization of TDP-43 from the nucleus to the cytoplasm, a pathological hallmark of ALS. We hypothesized expression of mutant Matrin 3 would lead to TDP-43 mislocalization, however the data did not support that hypothesis. The second aim of this study focuses on the mislocalization of TRanscription EXport (TREX) complex proteins within the nucleus. TREX proteins were studied based off of previous experiments suggesting that proteins within this complex bind to Matrin 3. The results showed differences in co-localization between each of these proteins and wild-type and mutant Matrin 3, confirming our earlier results. These findings can help increase our understanding of the mechanism of ALS while also setting the framework for future studies.