The brains of non-human primates are evolutionarily closest to the human brain with many structural, cognitive, and functional features. The brains of non-human primates have a complex network of brain connections involving the neocortex and prefrontal cortex, thus enabling the development of higher brain functions such as thinking, learning, decision-making, and judgment [
207,
208]. At the molecular level, the brains of non-human primates share more similar gene expression patterns with human brains than mouse brains do [
209]. These features, along with neuroanatomical and genetic similarities, make non-human primates highly desirable models for neurodegenerative diseases, including ALS. In 2012, Uchida et al. created TDP-43-overexpressing cynomolgus monkeys by injecting adeno-associated virus (AAV)-based human WT TDP-43 coding sequences into the C5-C6 spinal segment of cynomolgus monkeys [
210]. After 2-3 weeks, the monkeys exhibited progressive motor weakness and muscle atrophy with fasciculations in the muscles of the distal hand on the injection side; complete paralysis of the ipsilateral hand was observed 2-5 weeks after onset. At the same time, symptoms such as muscle atrophy and weakness also appeared in the contralateral hand. At the cellular level, diffuse mislocalization of TDP-43 in the cytoplasm was evident in α-MNs, but accumulation was infrequent, suggesting that this model does recapitulate some of the clinical features of ALS patients as well as pathological features in the spinal cord. In subsequent years, Borel et al. obtained marmoset and macaque
SOD1-ALS models by intrathecal delivery of AAV encoding an artificial SOD1-specific microRNA and determined reduced SOD1 levels in motoneurons and spinal cord slices [
211,
212]. Using the same technique, stereotaxic injection of
FUS-targeting shRNA in
Callithrix jacchus was used to generate a
FUS-ALS marmoset model [
213]. It is undeniable that gene silencing methods using viral delivery can play an important role in drug development and drug safety research. However, these monkeys were only manipulated with gene silencing to simulate the loss of
SOD1 and
FUS in the neurons of ALS patients and were not studied for neuropathological characteristics and behavioral phenotypes. Recently, to investigate the subcellular distribution of mutant TDP-43 in the monkey brain, Yin et al. injected a viral vector expressing mutant TDP-43 (M337V) directly into the substantia nigra of rhesus monkeys. Three months after injection, all the monkeys with TDP-43 injection developed significant left upper-extremity weakness at 2-4 weeks post-injection, and the severity increased and stabilized 3-4 months later [
214]. Most of the mutant TDP-43 was distributed in the cytoplasm of the monkey brain, which is consistent with the cytoplasmic distribution of TDP-43 in the brains of ALS patients and the spinal cords of monkeys overexpressing WT TDP-43. Notably, non-human primate-specific caspase-4, but not the mouse homolog caspase-11, removes the nuclear localization signal-containing N-terminal domain, leading to accumulation of fragmented TDP-43 in the cytoplasm [
210,
214]. The cleavage of TDP-43 mediated by the primate-specific caspase-4 provides additional clues to the cytoplasmic TDP-43-mediated gain-of-toxicity and points to potential therapeutic strategies to prevent or reduce TDP-43-associated neuropathology.