PSEN1 M146I (G>C)


Pathogenicity: Alzheimer's Disease : Pathogenic
Clinical Phenotype: Alzheimer's Disease
Reference Assembly: GRCh37 (105)
Position: Chr14:73640373 G>C
dbSNP ID: rs63750391
Coding/Non-Coding: Coding
Mutation Type: Point, Missense
Codon Change: ATG to ATC
Reference Isoform: PSEN1 isoform 1 (467 aa)
Genomic Region: Exon 5


This mutation was found in a Swedish family with six cases of documented dementia across four consecutive generations. The family was first described in 1946 (Essen-Möller, 1946) and followed up with genetic analysis 50 years later (Gustafson et al., 1998).

All six affected cases showed typical symptoms of AD. Myoclonic twitching, the language disorder palilalia, and major motor seizures were also reported. In addition, psychomotor slowness, increased muscular tension, a stiff, stooped gait, and a rapid loss of weight were observed. Cognitive decline started between 35 and 49 years of age.

Neuropathology was typical of AD in three cases, but unusually severe, with a pronounced involvement of central gray structures, including the claustrum, the nuclei around the third ventricle, the central thalamic nuclei, and the brain stem. There were no vascular lesions and amyloid angiopathy was very mild.

Biological Effect
The Aβ peptidome of neurons derived from iPSCs from a presymptomatic M146I (nucleotide change unspecified) mutation carrier revealed increased Aβ42/Aβ40 and Aβ42/Aβ38 ratios compared with controls (Arber et al., 2019; see April 2019 news). In contrast, Aβ38/Aβ40 and Aβ43/Aβ40 ratios remained unchanged. The elevated ratios suggest inefficient carboxypeptidase activity, predisposing neurons to accumulate longer Aβ fragments. Western blot analyses revealed a high degree of variablilty in mutant protein levels, consistent with altered protein stability.

M146 is the site of several AD-related mutations and is fully conserved in most animal presenilins. It is a semi-conservative substitution (hydrophobic amino acid) in an α-helix of a putative transmembrane domain.

Research Models

An iPSC line derived from skin fibroblasts of a 46-year-old symptomatic man carrying the mutation has been generated (Li et al., 2016). In addition, a transgenic minipig carrying the APP Swedish mutation and the PSEN1 M146I mutation has been created (Jakobsen et al., 2016).

Last Updated: 18 Apr 2019


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News Citations

  1. Familial Alzheimer’s Mutations: Different Mechanisms, Same End Result

Paper Citations

  1. . Generation of induced pluripotent stem cells (iPSCs) from an Alzheimer's disease patient carrying a M146I mutation in PSEN1. Stem Cell Res. 2016 Mar;16(2):334-7. Epub 2016 Jan 14 PubMed.
  2. . Expression of the Alzheimer's Disease Mutations AβPP695sw and PSEN1M146I in Double-Transgenic Göttingen Minipigs. J Alzheimers Dis. 2016 Jul 14;53(4):1617-30. PubMed.
  3. . A Family with Alzheimer's Disease. Acta Psychiatrica Scandinavica, September 1946
  4. . A 50-year perspective of a family with chromosome-14-linked Alzheimer's disease. Hum Genet. 1998 Mar;102(3):253-7. PubMed.
  5. . Familial Alzheimer's disease patient-derived neurons reveal distinct mutation-specific effects on amyloid beta. Mol Psychiatry. 2019 Apr 12; PubMed.

Further Reading


  1. . Self-Organizing 3D Human Neural Tissue Derived from Induced Pluripotent Stem Cells Recapitulate Alzheimer's Disease Phenotypes. PLoS One. 2016;11(9):e0161969. Epub 2016 Sep 13 PubMed.

Learn More

  1. Alzheimer Disease & Frontotemporal Dementia Mutation Database

Protein Diagram

Primary Papers

  1. . A 50-year perspective of a family with chromosome-14-linked Alzheimer's disease. Hum Genet. 1998 Mar;102(3):253-7. PubMed.

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