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Decoding neurodegeneration one cell at a time
Olivia Gautier, Thao P. Nguyen, Aaron D. Gitler
Olivia Gautier, Thao P. Nguyen, Aaron D. Gitler
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Review Series

Decoding neurodegeneration one cell at a time

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Abstract

Neurodegenerative diseases are characterized by protein misfolding and the selective vulnerability of specific neuronal subtypes. This selective vulnerability presents a paradox; most neurodegenerative disease genes are expressed broadly throughout the brain, and some ubiquitously, but only certain types of neurons are lost while others are resistant. The molecular basis for selective neuronal vulnerability has remained a mystery, but recent genomics technological innovations are starting to provide mechanistic insights. Here, we review how single-cell genomics techniques — single-cell transcriptomics, single-cell epigenomics, and spatial transcriptomics — advance our molecular understanding of selective vulnerability and neurodegeneration across Alzheimer disease, Parkinson disease, amyotrophic lateral sclerosis, frontotemporal dementia, and Huntington disease. Together, these approaches reveal the cell types affected in disease, define disease-associated molecular states, nominate candidate determinants of vulnerability and degeneration, and situate degenerating neurons within their local tissue context. Continued development and application of these techniques, including single-cell perturbation screens, will expand descriptive atlases of relevant cell types in health and disease and identify causal mechanisms, revealing the molecular basis of vulnerability and degeneration and informing therapeutic development.

Authors

Olivia Gautier, Thao P. Nguyen, Aaron D. Gitler

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Figure 1

Single-cell comparisons and readouts for neurodegenerative diseases.

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Single-cell comparisons and readouts for neurodegenerative diseases.
(A)...
(A) Comparative conditions in single-cell studies of neurodegeneration. Left: A resistant versus vulnerable neuronal subtype for a given neurodegenerative disease. Middle: A healthy versus degenerating neuron of the same cell type. Right: Homeostatic versus reactive glia (e.g., microglia and astrocytes) in disease. Contrasting these conditions with single-cell datasets reveals molecular correlates of selective vulnerability, degeneration, and glial responses. (B) Single-cell readouts that capture complementary biology. Left: Gene expression — scRNA-seq profiles define disease-associated transcriptional changes and cell states. Middle: Chromatin accessibility — scATAC-seq maps regulatory elements and transcription factor motif accessibility, which may promote disease-associated states. Right: Spatial context — spatial transcriptomics localizes cell states in situ, resolving the cellular neighbors of degenerating neurons. Together, these readouts help relate cell identity, cell state, regulatory factors, and spatial context, offering a more integrated view of disease biology.

Copyright © 2026 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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