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SETX is an RNA-DNA helicase that mediates resolution of co-transcriptional RNA:DNA hybrids (R-loops). The process of R-loop resolution is essential for the normal functioning of cells, including neurons. The molecular basis of ALS4 pathogenesis and the mechanism of R-loop resolution are unclear. We report that the zinc finger protein ZPR1 binds to RNA:DNA hybrids, recruits SETX onto R-loops and is critical for R-loop resolution. ZPR1 deficiency disrupts the integrity of R-loop resolution complexes containing SETX and causes increased R-loop accumulation throughout gene transcription. We uncover that SETX is a downstream target of ZPR1 and that overexpression of ZPR1 can rescue R-loop resolution complexe assembly in SETX-deficient cells but not vice versa. To uncover the mechanism of R-loop resolution, we examined the function of SETX-ZPR1 complexes using two genetic motor neuron disease models with altered R-loop resolution. Notably, chronic low levels of SETX-ZPR1 complexes onto R-loops result in a decrease of R-loop resolution activity causing an increase in R-loop levels in spinal muscular atrophy. ZPR1 overexpression increases recruitment of SETX onto R-loops, decreases R-loops and rescues the spinal muscular atrophy phenotype in motor neurons and patient cells. Strikingly, interaction of SETX with ZPR1 is disrupted in ALS4 patients that have heterozygous SETX (L389S) mutation. ZPR1 fails to recruit the mutant SETX homodimer but recruits the heterodimer with partially disrupted interaction between SETX and ZPR1. Interestingly, disruption of SETX-ZPR1 complexes causes increase in R-loop resolution activity leading to fewer R-loops in ALS4. Modulation of ZPR1 levels regulates R-loop accumulation and rescues the pathogenic R-loop phenotype in ALS4 patient cells. These findings originate a new concept, \u2018opposite alterations in a cell biological activity (R-loop resolution) result in similar pathogenesis (neurodegeneration) in different genetic motor neuron disorders\u2019. We propose that ZPR1 collaborates with SETX and may function as a molecular brake to regulate SETX-dependent R-loop resolution activity critical for the normal functioning of motor neurons.<\/jats:p>","DOI":"10.1093\/brain\/awab464","type":"journal-article","created":{"date-parts":[[2021,12,15]],"date-time":"2021-12-15T20:13:00Z","timestamp":1639599180000},"page":"3072-3094","source":"Crossref","is-referenced-by-count":47,"title":["Mutation in senataxin alters the mechanism of R-loop resolution in amyotrophic lateral sclerosis 4"],"prefix":"10.1093","volume":"145","author":[{"given":"Annapoorna","family":"Kannan","sequence":"first","affiliation":[{"name":"Center of Emphasis in Neurosciences, Texas Tech University Health Sciences Center El Paso , El Paso, TX 79905 , USA"},{"name":"Department of Molecular and Translational Medicine, Paul L. 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Foster School of Medicine, Texas Tech University Health Sciences Center El Paso , El Paso, TX 79905 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9205-9119","authenticated-orcid":false,"given":"Pratik","family":"Gangwani","sequence":"additional","affiliation":[{"name":"Automated Driving Compute System Architecture, GM Global Technical Center - Sloan Engineering Center , Warren, MI 48092 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Branzei","sequence":"additional","affiliation":[{"name":"The FIRC Institute of Molecular Oncology Foundation, IFOM Foundation , Milan 20139 , Italy"},{"name":"Istituto di Genetica Molecolare, Consiglio Nazionale delle Ricerche (IGM-CNR) , 27100 Pavia , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8575-9937","authenticated-orcid":false,"given":"Laxman","family":"Gangwani","sequence":"additional","affiliation":[{"name":"Center of Emphasis in Neurosciences, Texas Tech University Health Sciences Center El Paso , El Paso, TX 79905 , USA"},{"name":"Department of Molecular and Translational Medicine, Paul L. 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