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de la Rosa T, Berrocoso E, Scorza FA. Necropolitics of Death in Neurodegeneration. Cult Med Psychiatry 2024:10.1007/s11013-024-09855-7. [PMID: 38652343 DOI: 10.1007/s11013-024-09855-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/26/2024] [Indexed: 04/25/2024]
Abstract
Neurodegenerative diseases (ND) pose significant challenges for biomedicine in the twenty-first century, particularly considering the global demographic ageing and the subsequent increase in their prevalence. Characterized as progressive, chronic and debilitating, they often result in higher mortality rates compared with the general population. Research agendas and biomedical technologies are shaped by power relations, ultimately affecting patient wellbeing and care. Drawing on the concepts of bio- and necropolitics, introduced by philosophers Foucault and Mbembe, respectively, this perspective examines the interplay between the territoriality and governmentality around demographic ageing, ND and death, focussing on knowledge production as a dispositif of power by highlighting the marginal role that the phenomenon of mortality plays in the ND research landscape. We propose a shift into acknowledging the coloniality of knowledge and embracing its situatedness to attain knowledge 'from death', understood as an epistemic position from which novel approaches and practices could emerge.
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Affiliation(s)
- T de la Rosa
- Neurology Department, Escola Paulista de Medicina Universidade Federal de São Paulo, São Paulo, Brazil.
- Neuroscience Department, Universidad de Cádiz, Plaza del Falla 9, Facultad de Medicina 3 Planta, 11003, Cádiz, Spain.
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain.
| | - E Berrocoso
- Neuroscience Department, Universidad de Cádiz, Plaza del Falla 9, Facultad de Medicina 3 Planta, 11003, Cádiz, Spain
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - F A Scorza
- Neurology Department, Escola Paulista de Medicina Universidade Federal de São Paulo, São Paulo, Brazil
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2
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Pressman PS, Carter DJ, Ramos EM, Molden J, Smith K, Dino F, McMillan C, Irwin D, Rascovsky K, Ghoshal N, Knudtson M, Rademakers R, Geschwind D, Gendron T, Petrucelli L, Heuer H, Boeve BF, Barmada S, Boxer A, Tempini MLG, Rosen HJ. Symptomatic progression of frontotemporal dementia with the TARDBP I383V variant. Neurocase 2024; 30:39-47. [PMID: 38757415 DOI: 10.1080/13554794.2024.2354540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 05/02/2024] [Indexed: 05/18/2024]
Abstract
We present a longitudinal description of a man with the TARDBP I383V variant of frontotemporal dementia (FTD). His progressive changes in behavior and language resulted in a diagnosis of the right temporal variant of FTD, also called the semantic behavioral variant (sbvFTD). We also present data from a small series of patients with the TARDBP I383V variant who were enrolled in a nationwide FTD research collaboration (ALLFTD). These data support slowly progressive loss of semantic function. While semantic dementia is infrequently considered genetic, the TARDBP I383V variant seems to be an exception. Longitudinal analyses in larger samples are warranted.
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Affiliation(s)
- Peter S Pressman
- Alzheimer and Cognition Center, University of Colorado, Aurora, CO, US
| | - Danelle J Carter
- Alzheimer and Cognition Center, University of Colorado, Aurora, CO, US
| | - Eliana Marisa Ramos
- Department of Neurology, Anschutz Medical Campus, School of Medicine, University of California, Los Angeles, CA, US
| | - Joie Molden
- Department of Neurosurgery, University of Colorado, Boulder, CO, US
| | - Kaitlin Smith
- Alzheimer and Cognition Center, University of Colorado, Aurora, CO, US
| | - Francesca Dino
- Alzheimer and Cognition Center, University of Colorado, Aurora, CO, US
| | - Corey McMillan
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, US
| | - David Irwin
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, US
| | - Katya Rascovsky
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, US
| | - Nupur Ghoshal
- Departments of Neurology and Psychiatry, Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | | | - Rosa Rademakers
- NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, MO, USA
- Department of Neuroscience, Mayo Clinic Jacksonville, Jacksonville, FL, US
| | - Daniel Geschwind
- Division of Behavioral Neurology, Mayo Clinic College Rochester, Rochester, MN, USA
| | - Tania Gendron
- Department of Neuroscience, Mayo Clinic Jacksonville, Jacksonville, FL, US
| | - Leonard Petrucelli
- Department of Neuroscience, Mayo Clinic Jacksonville, Jacksonville, FL, US
| | - Hilary Heuer
- Memory and Aging Center, University of California, San Francisco, CA, USA
| | - Bradley F Boeve
- Department of Neuroscience, Mayo Clinic Jacksonville, Jacksonville, FL, US
| | - Sami Barmada
- Division of Behavioral Neurology, Mayo Clinic College Rochester, Rochester, MN, USA
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Adam Boxer
- Memory and Aging Center, University of California, San Francisco, CA, USA
| | | | - Howard J Rosen
- Memory and Aging Center, University of California, San Francisco, CA, USA
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Tan YL, Lo YKJ, Ho CSH. Psychological and social impacts of frontotemporal dementia on caregivers and family members - A systematic review. Gen Hosp Psychiatry 2024; 86:33-49. [PMID: 38064912 DOI: 10.1016/j.genhosppsych.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/29/2023] [Accepted: 11/29/2023] [Indexed: 01/27/2024]
Abstract
INTRODUCTION Frontotemporal dementia (FTD) may impose substantial psychological and social burdens on caregivers and family members that are unique from other forms of dementia due to its distinctive clinical characteristics. This systematic review investigated these impacts on caregivers and family members. METHODS A systematic search was conducted in the PubMed, Cochrane Library and Embase databases for relevant articles published from database inception to 23 March 2023. The methodological quality of the articles was evaluated using a checklist. RESULTS Thirty-six articles (six qualitative and thirty quantitative), including 5129 participants, were included in this review. Like other forms of dementia, FTD caregivers had significant caregiver burden levels and psychological impacts. Caregiver burden was associated with behavioural symptoms (e.g., apathy and disinhibition) and motor symptoms. The costs of caring for a patient with FTD were found to be higher than those for Alzheimer's disease. FTD patients often face challenges in obtaining a correct diagnosis and experience significant delays and multiple misdiagnoses. Healthcare professionals may also be less familiar with FTD than with Alzheimer's, leading to delayed diagnosis. This can cause considerable stress and deprive patients and caregivers of early intervention. CONCLUSION FTD is associated with significant costs and caregiver burden levels, and the difficulties faced by caregivers and family members can be unique and challenging in different aspects when compared to other forms of dementia. Better education about FTD for family members and healthcare professionals is required to improve the quality of life for both patients and caregivers, and more support needs to be provided at all stages of the disease.
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Affiliation(s)
- Ying Li Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Yee Kai Jeffrey Lo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Cyrus Su Hui Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore; Department of Psychological Medicine, National University Hospital, Singapore 119228, Singapore.
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Mo M, Xu H, Hoang MT, Jurado PG, Mostafaei S, Kåreholt I, Johnell K, Eriksdotter M, Garcia-Ptacek S. External Causes of Death From Death Certificates in Patients With Dementia. J Am Med Dir Assoc 2023; 24:1381-1388. [PMID: 37421971 DOI: 10.1016/j.jamda.2023.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/25/2023] [Accepted: 05/30/2023] [Indexed: 07/10/2023]
Abstract
OBJECTIVES We aim to analyze the risk of death from specific external causes, including falls, complications of medical and surgical care, unintentional injuries, and suicide, in dementia patients. DESIGN Swedish nationwide cohort study integrating 6 registers from May 1, 2007, through December 31, 2018, including the Swedish Registry for Cognitive/Dementia Disorders (SveDem). SETTING AND PARTICIPANTS Population-based study. Patients diagnosed with dementia from 2007 to 2018 and up to 4 controls matched on year of birth (±3 years), sex, and region of residence. METHODS The exposures of this study were diagnosis of dementia and dementia subtypes. Number of deaths and causes of mortality were obtained from death certificates compiled into the Cause of Death Register. Hazard ratios (HRs) and 95% CIs were estimated using Cox and flexible models, adjusted for sociodemographics, medical and psychiatric disorders. RESULTS The study population included 235,085 patients with dementia [96,760 men (41.2%); mean age 81.5 (SD 8.5) years] and 771,019 control participants [341,994 men (44.4%); mean age 79.9 (SD 8.6) years], over 3,721,687 person-years. Compared with control participants, patients with dementia presented increased risk for unintentional injuries (HR 3.30, 95% CI 3.19-3.40) and falls (HR 2.67, 95% CI 2.54-2.80) during old age (≥75 y), and suicide (HR 1.56, 95% CI 1.02-2.39) in middle age (<65 y). Suicide risk was 5.04 times higher (HR 6.04, 95% CI 4.22-8.66) in patients with both dementia and 2 or more psychiatric disorders relative to controls (incidence rate per person-years, 1.6 vs 0.3). For dementia subtypes, frontotemporal dementia had the highest risks of unintentional injuries (HR 4.28, 95% CI 2.80-6.52) and falls (HR 3.83, 95% CI 1.98-7.41), whereas subjects with mixed dementia were less likely to die from suicide (HR 0.11, 95% CI 0.03-0.46) and complications of medical and surgical care (HR 0.53, 95% CI 0.40-0.70) compared to controls. CONCLUSIONS AND IMPLICATIONS Suicide risk screening and psychiatric disorders management in early-onset dementia and early interventions for unintentional injuries and falls prevention in older dementia patients should be provided.
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Affiliation(s)
- Minjia Mo
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Hong Xu
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Minh Tuan Hoang
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Pol Grau Jurado
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Shayan Mostafaei
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Ingemar Kåreholt
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Department of Neurobiology, Aging Research Center, Center for Alzheimer Research, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Institute of Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Kristina Johnell
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Maria Eriksdotter
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Sara Garcia-Ptacek
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden.
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Ono R, Sakurai T, Sugimoto T, Uchida K, Nakagawa T, Noguchi T, Komatsu A, Arai H, Saito T. Mortality Risks and Causes of Death by Dementia Types in a Japanese Cohort with Dementia: NCGG-Stories. J Alzheimers Dis 2023; 92:487-498. [PMID: 36776074 PMCID: PMC10041427 DOI: 10.3233/jad-221290] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND Prognosis-related information regarding dementia needs to be updated, as changes in medical and long-term care environments for patients with dementia in recent decades may be improving the prognosis of the disease. OBJECTIVE We aimed to investigate the mortality, cause of death, and prognostic factors by types of dementia in a Japanese clinic-based cohort. METHODS The National Center for Geriatrics and Gerontology-Life Stories of People with Dementia consists of clinical records and prognostic data of patients who visited the Memory Clinic in Japan. Patients who attended the clinic between July 2010 and September 2018, or their close relatives, were asked about death information via a postal survey. A cohort of 3,229 patients (mean age, 76.9; female, 1,953) was classified into six groups: normal cognition (NC), mild cognitive impairment (MCI), Alzheimer's disease (AD), vascular dementia, dementia with Lewy bodies (DLB), and frontotemporal lobar degeneration. A Cox proportional hazards model was employed to compare the mortality of each type of dementia, MCI, and NC. RESULTS Patients with all types of dementia and MCI had higher mortality rates than those with NC (hazard risks: 2.61-5.20). The most common cause of death was pneumonia, followed by cancer. In the MCI, AD, and DLB groups, older age, male sex, and low cognitive function were common prognostic factors but not presence of apolipoprotein E ɛ4 allele. CONCLUSION Our findings suggest important differences in the mortality risk and cause of death among patients with dementia, which will be useful in advanced care planning and policymaking.
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Affiliation(s)
- Rei Ono
- Department of Physical Activity Research, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan.,Center for Comprehensive Care and Research on Memory Disorders, Hospital, National Center for Geriatrics and Gerontology, Aichi, Japan.,Department of Public Health, Kobe University Graduate School of Health Sciences, Hyogo, Japan
| | - Takashi Sakurai
- Center for Comprehensive Care and Research on Memory Disorders, Hospital, National Center for Geriatrics and Gerontology, Aichi, Japan.,Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan.,Department of Cognition and Behavior Science, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Taiki Sugimoto
- Center for Comprehensive Care and Research on Memory Disorders, Hospital, National Center for Geriatrics and Gerontology, Aichi, Japan.,Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Kazuaki Uchida
- Center for Comprehensive Care and Research on Memory Disorders, Hospital, National Center for Geriatrics and Gerontology, Aichi, Japan.,Department of Public Health, Kobe University Graduate School of Health Sciences, Hyogo, Japan
| | - Takeshi Nakagawa
- Department of Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Taiji Noguchi
- Department of Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Ayane Komatsu
- Department of Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Tami Saito
- Department of Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
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Frings L, Blazhenets G, Binder R, Bormann T, Hellwig S, Meyer PT. More extensive hypometabolism and higher mortality risk in patients with right- than left-predominant neurodegeneration of the anterior temporal lobe. Alzheimers Res Ther 2023; 15:11. [PMID: 36627641 PMCID: PMC9830748 DOI: 10.1186/s13195-022-01146-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 12/16/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Left-predominant neurodegeneration of the anterior temporal lobe (ATL) and the associated syndrome termed semantic variant primary progressive aphasia (svPPA) are well characterized. Less is known about right-predominant neurodegeneration of the ATL, which has been associated with the clinical syndrome named right temporal variant of frontotemporal dementia (rtvFTD). Here, we assessed glucose metabolism across the brain, cognitive performance, and mortality in patients with right-predominant neurodegeneration of the ATL. METHODS Patients with predominant hypometabolism of the ATL on FDG PET (as a measure of neurodegeneration) were retrospectively identified and categorized into those with asymmetrical right, left, or symmetric bilateral involvement (N = 10, 17, and 8). We compared whole-brain, normalized regional glucose metabolism using SPM12, cognitive performance on the CERAD Neuropsychological Assessment Battery, and mortality risk (age- and sex-adjusted Cox proportional hazard model) between groups. RESULTS Hypometabolism was most pronounced and extensive in patients with right-predominant neurodegeneration of the ATL. Beyond the right temporal lobe, right frontal and left temporal lobes were affected in these patients. Cognitive performance was similarly impaired in all three groups, with predominant naming and hippocampal-dependent memory deficits. Mortality risk was 6.1 times higher in patients with right- than left-predominant ATL neurodegeneration (p < 0.05). Median survival duration after PET was shortest in patients with right- and longest in patients with left-predominant ATL neurodegeneration (5.7 vs 8.3 years after examination). DISCUSSION More extensive neurodegeneration and shorter survival duration in patients with right- than left-predominant neurodegeneration of the ATL might indicate that the former consult memory clinics at a later disease stage, when symptoms like naming and episodic memory deficits have already emerged. At the time of diagnosis, the shorter survival duration of patients with right- than left-predominant ATL neurodegeneration should be kept in mind when counseling patients and caregivers.
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Affiliation(s)
- Lars Frings
- grid.5963.9Department of Nuclear Medicine, Medical Center - University of Freiburg and Faculty of Medicine, University of Freiburg, Freiburg, Germany ,grid.5963.9Center of Geriatrics and Gerontology, Medical Center - University of Freiburg and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ganna Blazhenets
- grid.5963.9Department of Nuclear Medicine, Medical Center - University of Freiburg and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Raphael Binder
- grid.5963.9Department of Nuclear Medicine, Medical Center - University of Freiburg and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Tobias Bormann
- grid.5963.9Department of Neurology and Clinical Neuroscience, Medical Center - University of Freiburg and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sabine Hellwig
- grid.5963.9Department of Psychiatry and Psychotherapy, Medical Center – University of Freiburg and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Philipp T. Meyer
- grid.5963.9Department of Nuclear Medicine, Medical Center - University of Freiburg and Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Buawangpong N, Pinyopornpanish K, Phinyo P, Jiraporncharoen W, Angkurawaranon C, Soontornpun A. Effect of Comorbidities on Ten-Year Survival in Patients with Dementia. J Alzheimers Dis 2023; 94:163-175. [PMID: 37212105 DOI: 10.3233/jad-221259] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
BACKGROUND There is a verified association between comorbidity and survival in patients with dementia. OBJECTIVE To describe the ten-year survival probability of patients with dementia and to identify the impact of comorbidity. METHODS The prognostic retrospective cohort study was conducted using data from adults with dementia who had visited the outpatient departments at Maharaj Nakorn Chiang Mai hospital between 2006 and 2012. Dementia was verified in accordance with standard practice guidelines. Secondary data detailing about patient age, gender, date of dementia diagnosis and death, types of dementia, and comorbidities at the time of dementia diagnosis was obtained from electronic medical records. The association between comorbidity, patients' underlying disease at dementia diagnosis, and overall survival were analyzed using a multivariable Cox proportional hazard model adjusted for age, gender, types of dementia, and other comorbidities. RESULTS Of the 702 patients, 56.9% were female. Alzheimer's disease (39.6%) was the most prevalent type of dementia. Median overall survival was 6.0 years (95% CI 5.5- 6.7). The comorbidities associated with a high risk of mortality included liver disease (aHR 2.70, 95% CI 1.46- 5.00), atrial fibrillation (aHR 2.15, 95% CI 1.29- 3.58), myocardial infarction (aHR 1.55, 95% CI 1.07- 2.26), and type 2 diabetes mellitus (aHR 1.40, 95% CI 1.13- 1.74). CONCLUSION Overall survival rate of patients with dementia in Thailand was comparable to previous studies. Several comorbidities were associated with a ten-year survival. The prognosis of patients with dementia may be improved by appropriate care of comorbidities.
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Affiliation(s)
- Nida Buawangpong
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, Thailand
| | - Kanokporn Pinyopornpanish
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, Thailand
| | - Phichayut Phinyo
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Musculoskeletal Science and Translational Research (MSTR), Chiang Mai University, Chiang Mai, Thailand
| | - Wichuda Jiraporncharoen
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, Thailand
| | - Chaisiri Angkurawaranon
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, Thailand
| | - Atiwat Soontornpun
- Department of Internal Medicine, Division of Neurology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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8
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Kashyap SN, Boyle NR, Roberson ED. Preclinical Interventions in Mouse Models of Frontotemporal Dementia Due to Progranulin Mutations. Neurotherapeutics 2023; 20:140-153. [PMID: 36781744 PMCID: PMC10119358 DOI: 10.1007/s13311-023-01348-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2023] [Indexed: 02/15/2023] Open
Abstract
Heterozygous loss-of-function mutations in progranulin (GRN) cause frontotemporal dementia (FTD), a leading cause of early-onset dementia characterized clinically by behavioral, social, and language deficits. There are currently no FDA-approved therapeutics for FTD-GRN, but this has been an active area of investigation, and several approaches are now in clinical trials. Here, we review preclinical development of therapies for FTD-GRN with a focus on testing in mouse models. Since most FTD-GRN-associated mutations cause progranulin haploinsufficiency, these approaches focus on raising progranulin levels. We begin by considering the disorders associated with altered progranulin levels, and then review the basics of progranulin biology including its lysosomal, neurotrophic, and immunomodulatory functions. We discuss mouse models of progranulin insufficiency and how they have been used in preclinical studies on a variety of therapeutic approaches. These include approaches to raise progranulin expression from the normal allele or facilitate progranulin production by the mutant allele, as well as approaches to directly increase progranulin levels by delivery across the blood-brain barrier or by gene therapy. Several of these approaches have entered clinical trials, providing hope that new therapies for FTD-GRN may be the next frontier in the treatment of neurodegenerative disease.
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Affiliation(s)
- Shreya N Kashyap
- Center for Neurodegeneration and Experimental Therapeutics, Alzheimer's Disease Center, Medical Scientist Training Program, Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Nicholas R Boyle
- Center for Neurodegeneration and Experimental Therapeutics, Alzheimer's Disease Center, Medical Scientist Training Program, Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Erik D Roberson
- Center for Neurodegeneration and Experimental Therapeutics, Alzheimer's Disease Center, Medical Scientist Training Program, Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA.
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9
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Chatzidimitriou E, Ioannidis P, Moraitou D, Konstantinopoulou E, Aretouli E. The cognitive and behavioral correlates of functional status in patients with frontotemporal dementia: A pilot study. Front Hum Neurosci 2023; 17:1087765. [PMID: 36923586 PMCID: PMC10009888 DOI: 10.3389/fnhum.2023.1087765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/30/2023] [Indexed: 02/24/2023] Open
Abstract
Objective: Frontotemporal dementia (FTD) impinges significantly on cognition, behavior, and everyday functioning. Goal of the present study is the detailed description of behavioral disturbances and functional limitations, as well as the investigation of associations between cognition, behavior, and functional impairment among FTD patients. Given the importance of maintaining a satisfying functional status as long as possible, this study also aims to identify the cognitive correlates of compensatory strategy use in this clinical group. Methods: A total of 13 patients diagnosed with FTD (behavioral variant FTD = 9, non-fluent variant primary progressive aphasia = 3, semantic dementia = 1) were administrated a broad range of neuropsychological tests for the assessment of different cognitive abilities. Behavioral symptomatology and performance on everyday activities were rated with informant-based measures. Descriptive statistics were used for the delineation of behavioral and functional patterns, whereas stepwise multiple regression analyses were performed to identify associations between cognition, behavior, and functional status. Results: Negative symptoms, especially apathy, were found to predominate in the behavior of FTD patients. Instrumental tasks, such as housework and leisure activities, appeared to be the most impaired functional domains. Working memory was the strongest cognitive correlate of performance across various domains of everyday functioning, whereas working memory along with short-term verbal memory accounted for a great proportion of variance in compensatory strategy use. Behavioral disturbances and especially negative symptoms were also found to contribute significantly to functional impairment in FTD. Conclusions: Executive dysfunction, as well as behavioral disturbances contribute significantly to functional disability in FTD. Early interventions tailored at these domains may have the potential to improve functional outcomes and delay the rate of functional decline among FTD patients.
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Affiliation(s)
- Electra Chatzidimitriou
- Laboratory of Cognitive Neuroscience, School of Psychology, Faculty of Philosophy, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Panagiotis Ioannidis
- B Department of Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Despina Moraitou
- Laboratory of Cognitive Neuroscience, School of Psychology, Faculty of Philosophy, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Konstantinopoulou
- Laboratory of Cognitive Neuroscience, School of Psychology, Faculty of Philosophy, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Aretouli
- School of Psychology, University of Ioannina, Ioannina, Greece
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Santamaría-García H, Ogonowsky N, Baez S, Palacio N, Reyes P, Schulte M, López A, Matallana D, Ibanez A. Neurocognitive patterns across genetic levels in behavioral variant frontotemporal dementia: a multiple single cases study. BMC Neurol 2022; 22:454. [PMID: 36474176 PMCID: PMC9724347 DOI: 10.1186/s12883-022-02954-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 07/06/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Behavioral variant frontotemporal dementia (bvFTD) has been related to different genetic factors. Identifying multimodal phenotypic heterogeneity triggered by various genetic influences is critical for improving diagnosis, prognosis, and treatments. However, the specific impact of different genetic levels (mutations vs. risk variants vs. sporadic presentations) on clinical and neurocognitive phenotypes is not entirely understood, specially in patites from underrepresented regions such as Colombia. METHODS Here, in a multiple single cases study, we provide systematic comparisons regarding cognitive, neuropsychiatric, brain atrophy, and gene expression-atrophy overlap in a novel cohort of FTD patients (n = 42) from Colombia with different genetic levels, including patients with known genetic influences (G-FTD) such as those with genetic mutations (GR1) in particular genes (MAPT, TARDBP, and TREM2); patients with risk variants (GR2) in genes associated with FTD (tau Haplotypes H1 and H2 and APOE variants including ε2, ε3, ε4); and sporadic FTD patients (S-FTD (GR3)). RESULTS We found that patients from GR1 and GR2 exhibited earlier disease onset, pervasive cognitive impairments (cognitive screening, executive functioning, ToM), and increased brain atrophy (prefrontal areas, cingulated cortices, basal ganglia, and inferior temporal gyrus) than S-FTD patients (GR3). No differences in disease duration were observed across groups. Additionally, significant neuropsychiatric symptoms were observed in the GR1. The GR1 also presented more clinical and neurocognitive compromise than GR2 patients; these groups, however, did not display differences in disease onset or duration. APOE and tau patients showed more neuropsychiatric symptoms and primary atrophy in parietal and temporal cortices than GR1 patients. The gene-atrophy overlap analysis revealed atrophy in regions with specific genetic overexpression in all G-FTD patients. A differential family presentation did not explain the results. CONCLUSIONS Our results support the existence of genetic levels affecting the clinical, neurocognitive, and, to a lesser extent, neuropsychiatric presentation of bvFTD in the present underrepresented sample. These results support tailored assessments characterization based on the parallels of genetic levels and neurocognitive profiles in bvFTD.
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Affiliation(s)
- Hernando Santamaría-García
- grid.41312.350000 0001 1033 6040PhD program in Neuroscience, Pontificia Universidad Javeriana, Bogotá, Colombia ,grid.448769.00000 0004 0370 0846Memory and cognition Center, Intellectus, Hospital Universitario San Ignacio, Bogotá, Colombia ,grid.266102.10000 0001 2297 6811Department of Neurology, Global Brain Health Institute, University of California San Francisco, San Francisco, CA USA
| | - Natalia Ogonowsky
- grid.441741.30000 0001 2325 2241CONICET & Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina
| | - Sandra Baez
- grid.7247.60000000419370714Faculty of Psychology, Universidad de los Andes, Bogotá, Colombia
| | - Nicole Palacio
- grid.14709.3b0000 0004 1936 8649Integrated Program in Neuroscience, McGill University, Montreal, Canada
| | - Pablo Reyes
- grid.41312.350000 0001 1033 6040PhD program in Neuroscience, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Michael Schulte
- grid.441741.30000 0001 2325 2241CONICET & Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina
| | - Andrea López
- grid.41312.350000 0001 1033 6040Pontificia Universidad Javeriana, Bogotá, Colombia ,grid.418089.c0000 0004 0620 2607Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Diana Matallana
- grid.41312.350000 0001 1033 6040Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Agustín Ibanez
- grid.440617.00000 0001 2162 5606Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez, Santiago de Chile, Chile ,grid.423606.50000 0001 1945 2152Cognitive Neuroscience Center (CNC), Universidad de San Andrés, & National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina ,Trinity Collegue of Dublin, Dublin, Irland ,grid.266102.10000 0001 2297 6811Global Brain Health Insititute, Universidad California San Francisco-Trinity College of Dublin, San Francisco, USA ,grid.8217.c0000 0004 1936 9705Global Brain Health Insititute, Universidad California San Francisco-Trinity College of Dublin, Dublin, Irland
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11
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Ellajosyula R, Narayanan J, Hegde S, Kamath V, Murgod U, Easwaran V, Seetharam R, Srinivasan M, Watson P. Delay in the diagnosis of dementia in urban India: Role of dementia subtype and age at onset. Int J Geriatr Psychiatry 2022; 37. [PMID: 36383431 DOI: 10.1002/gps.5843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 11/02/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Early diagnosis of dementia is crucial for timely intervention. However, frequently, there is a substantial delay in diagnosis. Therefore, it is essential to recognise and address the barriers to early diagnosis. These have not been systematically studied in India. We at a specialist memory clinic in India investigated the time from symptom onset to diagnosis of dementia and factors contributing to the delay. METHODS In this cross-sectional study, consecutive patients with dementia (n = 855) seen at a private hospital underwent a standard clinical assessment and investigations. The primary outcome variable was time from symptom onset to diagnosis (TTD). The association of age, education, gender, dementia subtype, and age of onset on TTD were examined using a univariate analysis of covariance. RESULTS The median TTD was 24 months; 43% were diagnosed after 24 months. There was a significant association between TTD and age at onset (young onset-median 36 months vs. late onset-24 months) and dementia subtype. Patients with vascular dementia were diagnosed significantly earlier as compared to patients with Alzheimer's disease (AD) and frontotemporal dementia (FTD) [median 18, 24, and 30 months, respectively]. There was no effect of gender or education on the TTD. CONCLUSION About 40% of patients with dementia were diagnosed more than 2 years after symptom onset, particularly young onset dementias and FTD. Our study findings highlight the gaps in diagnosing patients with dementia in urban India and have significant implications for developing and implementing multifaceted interventions to improve the early diagnosis of dementia.
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Affiliation(s)
- Ratnavalli Ellajosyula
- Department of Neurology, Manipal Hospitals, Bangalore, India.,Department of Neurology, Annasawmy Mudaliar Hospital, Bangalore, India
| | - Jwala Narayanan
- Department of Neurology, Manipal Hospitals, Bangalore, India.,Department of Neuropsychology, Annasawmy Mudaliar Hospital, Bangalore, India
| | - Soumya Hegde
- Department of Psychiatry, Annasawmy Mudaliar Hospital, Bangalore, India
| | - Vikram Kamath
- Department of Neurology, Apollo Hospitals, Bangalore, India
| | - Uday Murgod
- Department of Neurology, Manipal Hospitals, Bangalore, India
| | - Vandhana Easwaran
- Department of Neuropsychology, Annasawmy Mudaliar Hospital, Bangalore, India
| | | | | | - Peter Watson
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
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12
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Magrath Guimet N, Zapata-Restrepo LM, Miller BL. Advances in Treatment of Frontotemporal Dementia. J Neuropsychiatry Clin Neurosci 2022; 34:316-327. [PMID: 35578801 DOI: 10.1176/appi.neuropsych.21060166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In this review, the authors explored the clinical features of frontotemporal dementia (FTD), focusing on treatment. The clinical features of FTD are unique, with disinhibition, apathy, loss of empathy, and compulsions common. Motor changes occur later in the illness. The two major proteins that aggregate in the brain with FTD are tau and TDP-43, whereas a minority of patients aggregate FET proteins, primarily the FUS protein. Genetic causes include mutations in MAPT, GRN, and C9orf72. There are no medications that can slow FTD progression, although new therapies for the genetic forms of FTD are moving into clinical trials. Once a diagnosis is made, therapies should begin, focusing on the family and the patient. In the setting of FTD, families experience a severe burden associated with caregiving, and the clinician should focus on alleviating this burden. Advice around legal and financial issues is usually helpful. Careful consideration of environmental changes to cope with abnormal behaviors is essential. Most compounds that have been used to treat dementia of the Alzheimer's disease type are not effective in FTD, and cholinesterase inhibitors and memantine should be avoided. Although the data are scant, there is some evidence that antidepressants and second-generation antipsychotics may help individual patients.
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Affiliation(s)
- Nahuel Magrath Guimet
- Global Brain Health Institute, University of California, San Francisco (all authors); Institute of Neuroscience, Trinity College, Dublin (all authors); Department of Cognitive Neurology, Neuropsychiatry and Neuropsychology, Instituto Neurológico Fleni, Buenos Aires (Magrath Guimet); Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco (Miller); and Department of Medical Sciences, Pontifical Xaverian University Cali, Cali, Colombia (Zapata-Restrepo), Department of Psychiatry, Fundación Valle del Lili, Cali, Colombia (Zapata-Restrepo)
| | - Lina M Zapata-Restrepo
- Global Brain Health Institute, University of California, San Francisco (all authors); Institute of Neuroscience, Trinity College, Dublin (all authors); Department of Cognitive Neurology, Neuropsychiatry and Neuropsychology, Instituto Neurológico Fleni, Buenos Aires (Magrath Guimet); Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco (Miller); and Department of Medical Sciences, Pontifical Xaverian University Cali, Cali, Colombia (Zapata-Restrepo), Department of Psychiatry, Fundación Valle del Lili, Cali, Colombia (Zapata-Restrepo)
| | - Bruce L Miller
- Global Brain Health Institute, University of California, San Francisco (all authors); Institute of Neuroscience, Trinity College, Dublin (all authors); Department of Cognitive Neurology, Neuropsychiatry and Neuropsychology, Instituto Neurológico Fleni, Buenos Aires (Magrath Guimet); Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco (Miller); and Department of Medical Sciences, Pontifical Xaverian University Cali, Cali, Colombia (Zapata-Restrepo), Department of Psychiatry, Fundación Valle del Lili, Cali, Colombia (Zapata-Restrepo)
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13
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Sex influences clinical phenotype in frontotemporal dementia. Neurol Sci 2022; 43:5281-5287. [PMID: 35672480 PMCID: PMC9385756 DOI: 10.1007/s10072-022-06185-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 05/28/2022] [Indexed: 12/02/2022]
Abstract
Introduction Frontotemporal dementia (FTD) encompasses a wide spectrum of genetic, clinical, and histological findings. Sex is emerging as a potential biological variable influencing FTD heterogeneity; however, only a few studies explored this issue with nonconclusive results. Objective To estimate the role of sex in a single-center large cohort of FTD patients. Methods Five hundred thirty-one FTD patients were consecutively enrolled. Demographic, clinical, and neuropsychological features, survival rate, and serum neurofilament light (NfL) concentration were determined and compared between sex. Results The behavioral variant of FTD was more common in men, whereas primary progressive aphasia was overrepresented in women (p < 0.001). While global cognitive impairment was comparable, females had a more severe cognitive impairment, namely in Trail Making Test parts A and B (p = 0.003), semantic fluency (p = 0.03), Short Story Recall Test (p = 0.003), and the copy of Rey Complex Figure (p = 0.005). On the other hand, men exhibited more personality/behavioral symptoms (Frontal Behavior Inventory [FBI] AB, p = 0.003), displaying higher scores in positive FBI subscales (FBI B, p < 0.001). In particular, apathy (p = 0.02), irritability (p = 0.006), poor judgment (p = 0.033), aggressivity (p = 0.008), and hypersexuality (p = 0.006) were more common in men, after correction for disease severity. NfL concentration and survival were not statistically different between men and women (p = 0.167 and p = 0.645, respectively). Discussion The present study demonstrated that sex is a potential factor in determining FTD phenotype, while it does not influence survival. Although the pathophysiological contribution of sex in neurodegeneration is not well characterized yet, our findings highlight its role as deserving biological variable in FTD. Supplementary Information The online version contains supplementary material available at 10.1007/s10072-022-06185-7.
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14
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Loi SM, Tsoukra P, Chen Z, Wibawa P, Mijuskovic T, Eratne D, Di Biase MA, Evans A, Farrand S, Kelso W, Goh AM, Walterfang M, Velakoulis D. Mortality in dementia is predicted by older age of onset and cognitive presentation. Aust N Z J Psychiatry 2022; 56:852-861. [PMID: 34420425 DOI: 10.1177/00048674211041003] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Survival information in dementia is important for future planning and service provision. There have been limited Australian data investigating survival duration and risk factors associated with mortality in younger-onset dementia. METHODS This was a cross-sectional retrospective study investigating survival in inpatients with a diagnosis of dementia admitted to a tertiary neuropsychiatry service from 1991 to 2014. The Australian Institute of Health and Welfare National Death Index was used to obtain mortality information. RESULTS A total of 468 inpatients were identified, of which 75% had symptom onset at ⩽65 years of age (defined as younger-onset dementia). Dementia was categorised into four subtypes, Alzheimer's dementia, frontotemporal dementia, vascular dementia and other dementias; 72% of the patients had died. Overall median survival duration was 10.6 years with no significant differences in duration within the dementia subtypes (p = 0.174). Survival in older-onset dementia (symptom onset at >65 years of age) was about half of that in younger-onset dementia (median survival 6.3 years compared to 12.7 years, respectively). Independent predictors of mortality were having older-onset dementia (hazard ratio: 3.2) and having initial presenting symptoms being cognitive in nature (hazard ratio: 1.5). Females with an older-onset dementia had longer survival compared to males with an older-onset dementia, and this was reversed for younger-onset dementia. Older-onset dementia and younger-onset dementia conferred 3 and 6 times, respectively, increased risk of death compared to the general population. CONCLUSION This is the largest Australian study to date investigating survival and risk factors to mortality in dementia. We report important clinical information to patients with dementia and their families about prognosis which will assist with future planning. Our findings suggest that for both older-onset dementia and younger-onset dementia, 'new onset' psychiatric symptoms precede the cognitive symptoms of a neurodegenerative process. This, and sex differences in survival depending on the age of onset of the dementia warrant further investigation.
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Affiliation(s)
- Samantha M Loi
- Neuropsychiatry, NorthWestern Mental Health, Royal Melbourne Hospital, Parkville, VIC, Australia.,Melbourne Neuropsychiatry Centre, Department of Psychiatry, Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Paraskevi Tsoukra
- Department of Neurology, Evangelismos General Hospital, Athens, Greece
| | - Zhiben Chen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Pierre Wibawa
- Neuropsychiatry, NorthWestern Mental Health, Royal Melbourne Hospital, Parkville, VIC, Australia
| | | | - Dhamidhu Eratne
- Neuropsychiatry, NorthWestern Mental Health, Royal Melbourne Hospital, Parkville, VIC, Australia.,Melbourne Neuropsychiatry Centre, Department of Psychiatry, Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Maria A Di Biase
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia.,Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Andrew Evans
- Department of Medicine, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Sarah Farrand
- Neuropsychiatry, NorthWestern Mental Health, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Wendy Kelso
- Neuropsychiatry, NorthWestern Mental Health, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Anita My Goh
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia.,National Ageing Research Institute, Parkville, VIC, Australia
| | - Mark Walterfang
- Neuropsychiatry, NorthWestern Mental Health, Royal Melbourne Hospital, Parkville, VIC, Australia.,Melbourne Neuropsychiatry Centre, Department of Psychiatry, Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia.,The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Dennis Velakoulis
- Neuropsychiatry, NorthWestern Mental Health, Royal Melbourne Hospital, Parkville, VIC, Australia.,Melbourne Neuropsychiatry Centre, Department of Psychiatry, Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
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15
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Roos P, Johannsen P, Lindquist SG, Brown JM, Waldemar G, Duno M, Nielsen TT, Budtz‐Jørgensen E, Gydesen S, Holm IE, Collinge J, Isaacs AM, Nielsen JE, Gade A, Stokholm J, Thusgaard T, Fisher EM, Englund E. Six generations of CHMP2B-mediated Frontotemporal Dementia: Clinical features, predictive testing, progression, and survival. Acta Neurol Scand 2022; 145:529-540. [PMID: 34997757 DOI: 10.1111/ane.13578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 11/04/2021] [Accepted: 11/07/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Chromosome 3-linked frontotemporal dementia (FTD-3) is caused by a c.532-1G > C mutation in the CHMP2B gene. It is extensively studied in a Danish family comprising one of the largest families with an autosomal dominantly inherited frontotemporal dementia (FTD). This retrospective cohort study utilizes demographics to identify risk factors for onset, progression, life expectancy, and death in CHMP2B-mediated FTD. The pedigree of 528 individuals in six generations is provided, and clinical descriptions are presented. Choices of genetic testing are evaluated. MATERIALS AND METHODS Demographic and lifestyle factors were assessed in survival analysis in all identified CHMP2B mutation carriers (44 clinically affected FTD-3 patients and 16 presymptomatic CHMP2B mutation carriers). Predictors of onset and progression included sex, parental disease course, education, and vascular risk factors. Life expectancy was established by matching CHMP2B mutation carriers with average life expectancies in Denmark. RESULTS Disease course was not correlated to parental disease course and seemed unmodified by lifestyle factors. Diagnosis was recognized at an earlier age in members with higher levels of education, probably reflecting an early dysexecutive syndrome, unmasked earlier in people with higher work-related requirements. Carriers of the CHMP2B mutation had a significant reduction in life expectancy of 13 years. Predictive genetic testing was chosen by 20% of at-risk family members. CONCLUSIONS CHMP2B-mediated FTD is substantiated as an autosomal dominantly inherited disease of complete penetrance. The clinical phenotype is a behavioral variant FTD. The disease course is unpredictable, and life expectancy is reduced. The findings may be applicable to other genetic FTD subtypes.
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Affiliation(s)
- Peter Roos
- Danish Dementia Research Centre Department of Neurology Rigshospitalet University of Copenhagen Denmark
| | - Peter Johannsen
- Danish Dementia Research Centre Department of Neurology Rigshospitalet University of Copenhagen Denmark
- Medical & Science Novo Nordisk A/S Søborg Denmark
| | - Suzanne G. Lindquist
- Danish Dementia Research Centre Department of Neurology Rigshospitalet University of Copenhagen Denmark
- Department of Clinical Genetics, Rigshospitalet University of Copenhagen Denmark
| | | | - Gunhild Waldemar
- Danish Dementia Research Centre Department of Neurology Rigshospitalet University of Copenhagen Denmark
| | - Morten Duno
- Department of Clinical Genetics, Rigshospitalet University of Copenhagen Denmark
| | - Troels T. Nielsen
- Danish Dementia Research Centre Department of Neurology Rigshospitalet University of Copenhagen Denmark
| | - Esben Budtz‐Jørgensen
- Section of Biostatistics Department of Public Health University of Copenhagen Denmark
| | | | - Ida E. Holm
- Department of Pathology Aalborg University Hospital Randers Denmark
| | - John Collinge
- MRC Prion Unit at UCL UCL Institute of Prion Diseases Courtauld Building London UK
| | - Adrian M. Isaacs
- Department of Neuromuscular Diseases UCL Institute of Neurology Queen Square London UK
- UK Dementia Research Institute at UCL UCL Institute of Neurology Queen Square London UK
| | - Jørgen E. Nielsen
- Danish Dementia Research Centre Department of Neurology Rigshospitalet University of Copenhagen Denmark
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Riley KJ, Graner BD, Veronesi MC. The tauopathies: Neuroimaging characteristics and emerging experimental therapies. J Neuroimaging 2022; 32:565-581. [PMID: 35470528 PMCID: PMC9545715 DOI: 10.1111/jon.13001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 03/10/2022] [Accepted: 03/28/2022] [Indexed: 11/29/2022] Open
Abstract
The tauopathies are a heterogeneous group of neurodegenerative disorders in which the prevailing underlying disease process is intracellular deposition of abnormal misfolded tau protein. Diseases often categorized as tauopathies include progressive supranuclear palsy, chronic traumatic encephalopathy, corticobasal degeneration, and frontotemporal lobar degeneration. Tauopathies can be classified through clinical assessment, imaging findings, histologic validation, or molecular biomarkers tied to the underlying disease mechanism. Many tauopathies vary in their clinical presentation and overlap substantially in presentation, making clinical diagnosis of a specific primary tauopathy difficult. Anatomic imaging findings are also rarely specific to a single tauopathy, and when present may not manifest until well after the point at which therapy may be most impactful. Molecular biomarkers hold the most promise for patient care and form a platform upon which emerging diagnostic and therapeutic applications could be developed. One of the most exciting developments utilizing these molecular biomarkers for assessment of tau deposition within the brain is tau‐PET imaging utilizing novel ligands that specifically target tau protein. This review will discuss the background, significance, and clinical presentation of each tauopathy with additional attention to the pathologic mechanisms at the protein level. The imaging characteristics will be outlined with select examples of emerging imaging techniques. Finally, current treatment options and emerging therapies will be discussed. This is by no means a comprehensive review of the literature but is instead intended for the practicing radiologist as an overview of a rapidly evolving topic.
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Affiliation(s)
- Kalen J Riley
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Brian D Graner
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Michael C Veronesi
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Survival in Korean Patients with Frontotemporal Dementia Syndrome: Association with Behavioral Features and Parkinsonism. J Clin Med 2022; 11:jcm11082260. [PMID: 35456351 PMCID: PMC9025342 DOI: 10.3390/jcm11082260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 04/14/2022] [Accepted: 04/15/2022] [Indexed: 02/05/2023] Open
Abstract
We investigated the survival time of each clinical syndrome of frontotemporal dementia (FTD) and the impacts of behavioral and motor features on survival of FTD. A total of 216 patients with FTD [82 behavioral variant FTD (bvFTD), 78 semantic variant primary progressive aphasia (svPPA), 43 non-fluent/agrammatic variant PPA (nfvPPA), 13 FTD-motor neuron disease (MND)] were enrolled from 16 centers across Korea. Behaviors and parkinsonism were assessed using the Frontal Behavioral Inventory and Unified Parkinson’s Disease Rating Scale Part III, respectively. The Kaplan–Meier method was used for the survival analysis and the Cox proportional hazards model was applied for analysis of the effect of behavioral and motor symptoms on survival, after controlling vascular risk factors and cancer. An overall median survival of FTD was 12.1 years. The survival time from onset was shortest for FTD-MND and longest for svPPA. The median survival time of patients with bvFTD was unavailable but likely comparable to that of patients with nfvPPA. In the bvFTD group, negative behavioral symptoms and akinetic rigidity were significantly associated with survival. In the nfvPPA group, the presence of dysarthria had a negative impact on survival. These findings provide useful information to clinicians planning for care.
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Abstract
OBJECTIVES While early diagnosis of younger-onset dementia (YOD) is crucial in terms of accessing appropriate services and future planning, diagnostic delays are common. This study aims to identify predictors of delay to diagnosis in a large sample of people with YOD and to investigate the impact of a specialist YOD service on this time to diagnosis. DESIGN A retrospective cross-sectional study. SETTING The inpatient unit of a tertiary neuropsychiatry service in metropolitan Victoria, Australia. PARTICIPANTS People diagnosed with a YOD. MEASUREMENTS AND METHODS We investigated the following predictors using general linear modeling: demographics including sex and location, age at onset, dementia type, cognition, psychiatric diagnosis, and number of services consulted with prior to diagnosis. RESULTS A total of 242 inpatients were included. The mean time to diagnosis was 3.4 years. Significant predictors of delay included younger age at onset, dementia type other than Alzheimer's disease (AD) and behavioral-variant frontotemporal dementia (bvFTD), and increased number of services consulted. These predictors individually led to an increased diagnostic delay of approximately 19 days, 5 months, and 6 months, respectively. A specialized YOD service reduced time to diagnosis by 12 months. CONCLUSION We found that younger age at onset, having a dementia which was not the most commonly occurring AD or bvFTD, and increasing number of services were significant predictors of diagnostic delay. A novel result was that a specialist YOD service may decrease diagnostic delay, highlighting the importance of such as service in reducing time to diagnosis as well as providing post-diagnostic support.
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19
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Loi SM, Tsoukra P, Chen Z, Wibawa P, Eratne D, Kelso W, Walterfang M, Velakoulis D. Risk factors to mortality and causes of death in frontotemporal dementia: An Australian perspective. Int J Geriatr Psychiatry 2021; 37. [PMID: 34921446 DOI: 10.1002/gps.5668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 12/15/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Frontotemporal dementia (FTD) is a common cause of dementia in younger people. There is less information known about risk factors to mortality such as the type of symptom onset and cause of death in this group. METHOD This was a retrospective file review of inpatients with FTD admitted to a tertiary neuropsychiatry unit located in Australia from 1992 to 2014. Mortality information including linkage of names and causes of death were obtained from the Australian Institute Health and Welfare National Death Index. RESULTS One hundred inpatients were diagnosed with FTD, including behavioural-variant, language-variant FTDs and FTD-motor neuron disease (FTD-MND). Mean age was 52.8 years (SD = 10, range 31-76 years). Sixty-seven of them had died at linkage. Median survival of the sample was 10.5 years and FTD-MND had the shortest survival, 3.5 years. Increasing age of onset and FTD-MND were found to be significant predictors of association for mortality. Compared to the general population, having a FTD had an 8× increased risk of death. Females had double the standardised mortality ratio compared to males. DISCUSSION This study provides important prognostic information for people diagnosed with FTD living in Australia. It highlights the importance of obtaining a definitive diagnosis as early as possible for future planning. More investigation into the relationship of symptom onset type and sex differences in FTD is required.
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Affiliation(s)
- Samantha M Loi
- Neuropsychiatry, NorthWestern Mental Health, Melbourne Health, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia
| | | | - Zhibin Chen
- School of Public Health and Preventive Medicine, Monash University, Clayton, Australia
| | - Pierre Wibawa
- Neuropsychiatry, NorthWestern Mental Health, Melbourne Health, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Dhamidhu Eratne
- Neuropsychiatry, NorthWestern Mental Health, Melbourne Health, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia
- Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia
| | - Wendy Kelso
- Neuropsychiatry, NorthWestern Mental Health, Melbourne Health, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Mark Walterfang
- Neuropsychiatry, NorthWestern Mental Health, Melbourne Health, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia
| | - Dennis Velakoulis
- Neuropsychiatry, NorthWestern Mental Health, Melbourne Health, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia
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20
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Tastevin M, Lavoie M, de la Sablonnière J, Carrier-Auclair J, Laforce R. Survival in the Three Common Variants of Primary Progressive Aphasia: A Retrospective Study in a Tertiary Memory Clinic. Brain Sci 2021; 11:brainsci11091113. [PMID: 34573135 PMCID: PMC8466819 DOI: 10.3390/brainsci11091113] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 08/19/2021] [Accepted: 08/22/2021] [Indexed: 11/16/2022] Open
Abstract
Knowledge on the natural history of the three main variants of primary progressive aphasia (PPA) is lacking, particularly regarding mortality. Moreover, advanced stages and end of life issues are rarely discussed with caregivers and families at diagnosis, which can cause more psychological distress. We analyzed data from 83 deceased patients with a diagnosis of PPA. We studied survival in patients with a diagnosis of logopenic variant (lvPPA), semantic variant (svPPA), or non-fluent variant (nfvPPA) and examined causes of death. From medical records, we retrospectively collected data for each patient at several time points spanning five years before the first visit to death. When possible, interviews were performed with proxies of patients to complete missing data. Results showed that survival from symptom onset and diagnosis was significantly longer in svPPA than in lvPPA (p = 0.002) and nfvPPA (p < 0.001). No relevant confounders were associated with survival. Mean survival from symptom onset was 7.6 years for lvPPA, 7.1 years for nfvPPA, and 12 years for svPPA. The most common causes of death were natural cardio-pulmonary arrest and pneumonia. Aspiration pneumonia represented 23% of deaths in nfvPPA. In conclusion, this pilot study found significant differences in survival between the three variants of PPA with svPPA showing the longest and nfvPPA showing more neurologically-related causes of death.
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21
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Lasaponara S, Marson F, Doricchi F, Cavallo M. A Scoping Review of Cognitive Training in Neurodegenerative Diseases via Computerized and Virtual Reality Tools: What We Know So Far. Brain Sci 2021; 11:528. [PMID: 33919244 PMCID: PMC8143131 DOI: 10.3390/brainsci11050528] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/17/2021] [Accepted: 04/19/2021] [Indexed: 11/17/2022] Open
Abstract
Most prevalent neurodegenerative diseases such as Alzheimer's disease, frontotemporal dementia, Parkinson's disease and multiple sclerosis are heterogeneous in their clinical profiles and underlying pathophysiology, although they typically share the presence of cognitive impairment that worsens significantly during the course of the disease. Viable pharmacological options for cognitive symptoms in these clinical conditions are currently lacking. In recent years, several studies have started to apply Computerized Cognitive Training (CCT) and Virtual Reality (VR) tools to try and contrast patients' cognitive decay over time. However, no in-depth literature review of the contribution of these promising therapeutic options across main neurodegenerative diseases has been conducted yet. The present paper reports the state-of-the-art of CCT and VR studies targeting cognitive impairment in most common neurodegenerative conditions. Our twofold aim is to point out the scientific evidence available so far and to support health professionals to consider these promising therapeutic tools when planning rehabilitative interventions, especially when the access to regular and frequent hospital consultations is not easy to be provided.
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Affiliation(s)
- Stefano Lasaponara
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (S.L.); (F.D.)
- Department of Human Sciences, LUMSA University, 00193 Rome, Italy
| | - Fabio Marson
- Research Institute for Neuroscience, Education and Didactics, Fondazione Patrizio Paoletti, 06081 Assisi, Italy;
- Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy
| | - Fabrizio Doricchi
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (S.L.); (F.D.)
- Department of Neuropsychology, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Marco Cavallo
- Faculty of Psychology, eCampus University, 22060 Novedrate, Italy
- Clinical Psychology Service, Saint George Foundation, 12030 Cavallermaggiore, Italy
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22
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van den Berg E, Poos JM, Jiskoot LC, Montagne B, Kessels RPC, Franzen S, van Hemmen J, Eikelboom WS, Heijboer EGC, de Kriek J, van der Vlist A, de Jong FJ, van Swieten JC, Seelaar H, Papma JM. Impaired Knowledge of Social Norms in Dementia and Psychiatric Disorders: Validation of the Social Norms Questionnaire-Dutch Version (SNQ-NL). Assessment 2021; 29:1236-1247. [PMID: 33855860 PMCID: PMC9301163 DOI: 10.1177/10731911211008234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The Social Norms Questionnaire–Dutch version (SNQ-NL) measures the ability to
understand and identify social boundaries. We examined the psychometric
characteristics of the SNQ-NL and its ability to differentiate between patients
with behavioral variant frontotemporal dementia (bvFTD; n =
23), Alzheimer’s dementia (AD; n = 26), chronic psychiatric
disorders (n = 27), and control participants
(n = 92). Between-group differences in the Total score,
Break errors, and Overadhere errors were examined and associations with
demographic variables and other cognitive functions were explored. Results
showed that the SNQ-NL Total Score and Break errors differed between patients
with AD and bvFTD, but not between patients with bvFTD and psychiatric
disorders. Modest correlations with age, sex, and education were observed. The
SNQ-NL Total score and Break errors correlated significantly with emotion
recognition and verbal fluency but not with processing speed or mental
flexibility. In conclusion, the SNQ-NL has sufficient construct validity and can
be used to investigate knowledge of social norms in clinical populations.
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Affiliation(s)
- E van den Berg
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - J M Poos
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - L C Jiskoot
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, the Netherlands.,Dementia Research Center, University College London, London, UK
| | - B Montagne
- Psychodiagnostic department Eemland, GGZ Centraal Psychiatric Center, Amersfoort, the Netherlands.,Experimental Psychology, Helmholtz Institute, Utrecht University, The Netherlands
| | - R P C Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, the Netherlands.,Department of Medical Psychology & Radboud umc Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands.,Vincent van Gogh Institute of Psychiatry, Venray, The Netherlands
| | - S Franzen
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - J van Hemmen
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - W S Eikelboom
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - E G C Heijboer
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - J de Kriek
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - A van der Vlist
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - F J de Jong
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - J C van Swieten
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - H Seelaar
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - J M Papma
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
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23
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El-Wahsh S, Finger EC, Piguet O, Mok V, Rohrer JD, Kiernan MC, Ahmed RM. Predictors of survival in frontotemporal lobar degeneration syndromes. J Neurol Neurosurg Psychiatry 2021; 92:jnnp-2020-324349. [PMID: 33441385 DOI: 10.1136/jnnp-2020-324349] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/26/2020] [Accepted: 12/14/2020] [Indexed: 12/11/2022]
Abstract
After decades of research, large-scale clinical trials in patients diagnosed with frontotemporal lobar degeneration (FTLD) are now underway across multiple centres worldwide. As such, refining the determinants of survival in FTLD represents a timely and important challenge. Specifically, disease outcome measures need greater clarity of definition to enable accurate tracking of therapeutic interventions in both clinical and research settings. Multiple factors potentially determine survival, including the clinical phenotype at presentation; radiological patterns of atrophy including markers on both structural and functional imaging; metabolic factors including eating behaviour and lipid metabolism; biomarkers including both serum and cerebrospinal fluid markers of underlying pathology; as well as genetic factors, including both dominantly inherited genes, but also genetic modifiers. The present review synthesises the effect of these factors on disease survival across the syndromes of frontotemporal dementia, with comparison to amyotrophic lateral sclerosis, progressive supranuclear palsy and corticobasal syndrome. A pathway is presented that outlines the utility of these varied survival factors for future clinical trials and drug development. Given the complexity of the FTLD spectrum, it seems unlikely that any single factor may predict overall survival in individual patients, further suggesting that a precision medicine approach will need to be developed in predicting disease survival in FTLD, to enhance drug target development and future clinical trial methodologies.
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Affiliation(s)
- Shadi El-Wahsh
- Department of Neurology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Elizabeth C Finger
- Department of Clinicial Neurological Sciences, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Olivier Piguet
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Vincent Mok
- Gerald Choa Neuroscience Centre, Lui Che Woo Institute of Innovative Medicine, Margaret K.L. Cheung Research Centre for Management of Parkinsonism, Division of Neurology, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Matthew C Kiernan
- Department of Neurology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Rebekah M Ahmed
- Department of Neurology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
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24
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The capacity to consent to treatment in amyotrophic lateral sclerosis: a preliminary report. J Neurol 2020; 268:219-226. [PMID: 32766931 DOI: 10.1007/s00415-020-10136-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/28/2020] [Accepted: 07/30/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Facing the relentless worsening of their condition, ALS patients are required to make decisions on treatments and end-of-life care. A cognitive impairment showed to be a negative prognostic factor in ALS patients, perhaps affecting the ability to make informed decisions. Notwithstanding its crucial role, the capacity to consent to treatment (CCT) has never been evaluated in these patients. OBJECTIVES To assess the CCT in an ALS cohort in comparison to a control group, and to study the effects of demographic and clinical variables on this high-level cognitive function. METHODS 102 ALS patients and 106 healthy controls (HC) were enrolled. CCT was assessed using the MacArthur Competence Assessment Tool for Treatment (MAC-CAT-T) and the performance was classified into the three CCT outcomes (full credit, partial credit, no credit). Cognitive and psychological variables were assessed by MMSE, phonemic fluencies, Frontal System Behavioural Scale (FrSBe), and ALS Depression Inventory (ADI). Clinical and demographic variables were analyzed as possible predictors of the MAC-CAT-T outcomes. After a 1-year follow-up, CCT and neuropsychological assessments were repeated. RESULTS Most ALS patients (i.e., from 75 to 83% according to the different sub-items) retain full CCT. However, a subpopulation of the ALS patients showed a reduced CCT with respect to the HC. Age, education, phonemic fluency, and depression appeared related to the CCT outcomes. After 1 year, only the reasoning items worsened. CONCLUSIONS This is a preliminary report suggesting that the large majority of ALS patients can retain full ability to choose between treatment options. However, demographic and neuropsychological variables may affect CCT, pointing to the need for special attention to the consent disclosure in this disease.
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25
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Perez M, Amayra I, Lazaro E, García M, Martínez O, Caballero P, Berrocoso S, López-Paz JF, Al-Rashaida M, Rodríguez AA, Luna P, Varona L. Intrusion errors during verbal fluency task in amyotrophic lateral sclerosis. PLoS One 2020; 15:e0233349. [PMID: 32469951 PMCID: PMC7259757 DOI: 10.1371/journal.pone.0233349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 05/05/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Numerous studies have noted the presence of a dysexecutive component of the ALS-FTD. The most widely replicated result refers to the significantly reduced verbal fluency of ALS patients when compared to healthy people. As ALS patients have motor alterations that interfere with production, qualitative studies have the advantage of being independent of the degree of motor disability and revealing patients' cognitive state. This study examined the production differences between 42 ALS patients who presented with different degrees of dementia and motor impairment and 42 healthy people. Production processes were studied by extending the administration time of a letter fluency task to 2 minutes for the phonemic verbal fluency (PVF) and semantic verbal fluency (SVF) categories. This ensured that the qualitative aspects of verbal fluency were addressed, paying special attention to the new perseverations and intrusions, as well as any clinical correlates that may exist. RESULTS The ALS patients produced a significantly lower number of responses in PVF (p = .017) and SVF (p = .008). The rest of the indicators for frontal lobe alteration also suggested the existence of a dysfunction. The most remarkable results were the number of intrusions on the PVF task, which was much higher in the ALS group (p = .002). However, the number of perseverations did not differ significantly. CONCLUSIONS This study highlights the value of intrusions in addressing cognitive deterioration in ALS patients. This deterioration seems to be independent of the degree of motor impairment and of behavioural alterations. Therefore, the value of the intromissions on the verbal fluency task was highlighted as an indicator of a new cognitive alteration, which can be easily evaluated, even retrospectively.
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Affiliation(s)
| | | | | | | | | | - Patricia Caballero
- University of Deusto, Vizcaya, Spain
- Clinical Psychology, Galdakao University Hospital, Vizcaya, Spain
| | | | | | | | | | | | - Luis Varona
- Department of Neurology, Basurto University Hospital, Vizcaya, Spain
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26
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Scarioni M, Gami-Patel P, Timar Y, Seelaar H, van Swieten JC, Rozemuller AJM, Dols A, Scarpini E, Galimberti D, Hoozemans JJM, Pijnenburg YAL, Dijkstra AA. Frontotemporal Dementia: Correlations Between Psychiatric Symptoms and Pathology. Ann Neurol 2020; 87:950-961. [PMID: 32281118 PMCID: PMC7318614 DOI: 10.1002/ana.25739] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/03/2020] [Accepted: 04/03/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The pathology of frontotemporal dementia, termed frontotemporal lobar degeneration (FTLD), is characterized by distinct molecular classes of aggregated proteins, the most common being TAR DNA-binding protein-43 (TDP-43), tau, and fused in sarcoma (FUS). With a few exceptions, it is currently not possible to predict the underlying pathology based on the clinical syndrome. In this study, we set out to investigate the relationship between pathological and clinical presentation at single symptom level, including neuropsychiatric features. METHODS The presence or absence of symptoms from the current clinical guidelines, together with neuropsychiatric features, such as hallucinations and delusions, were scored and compared across pathological groups in a cohort of 150 brain donors. RESULTS Our cohort consisted of 68.6% FTLD donors (35.3% TDP-43, 28% tau, and 5.3% FUS) and 31.3% non-FTLD donors with a clinical diagnosis of frontotemporal dementia and a different pathological substrate, such as Alzheimer's disease (23%). The presence of hyperorality points to FTLD rather than non-FTLD pathology (p < 0.001). Within the FTLD group, hallucinations in the initial years of the disease were related to TDP-43 pathology (p = 0.02), including but not limited to chromosome 9 open reading frame 72 (C9orf72) repeat expansion carriers. The presence of perseverative or compulsive behavior was more common in the TDP-B and TDP-C histotypes (p = 0.002). INTERPRETATION Our findings indicate that neuropsychiatric features are common in FTLD and form an important indicator of underlying pathology. In order to allow better inclusion of patients in targeted molecular trials, the routine evaluation of patients with frontotemporal dementia should include the presence and nature of neuropsychiatric symptoms. ANN NEUROL 2020;87:950-961.
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Affiliation(s)
- Marta Scarioni
- Department of Pathology, Amsterdam University Medical Centers, Location VUmc, Amsterdam Neuroscience, Amsterdam, The Netherlands.,Department of Neurology, Amsterdam University Medical Centers, Location VUmc, Alzheimer Center, Amsterdam, The Netherlands.,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Dino Ferrari Center, University of Milan, Milan, Italy
| | - Priya Gami-Patel
- Department of Pathology, Amsterdam University Medical Centers, Location VUmc, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Yannick Timar
- Department of Neurology, Amsterdam University Medical Centers, Location VUmc, Alzheimer Center, Amsterdam, The Netherlands
| | - Harro Seelaar
- Department of Neurology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - John C van Swieten
- Department of Neurology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Annemieke J M Rozemuller
- Department of Pathology, Amsterdam University Medical Centers, Location VUmc, Amsterdam Neuroscience, Amsterdam, The Netherlands.,Netherlands Institute for Neuroscience, Amsterdam, The Netherlands
| | - Annemiek Dols
- Department of Neurology, Amsterdam University Medical Centers, Location VUmc, Alzheimer Center, Amsterdam, The Netherlands.,Department of Old Age Psychiatry, GGZinGeest/Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Elio Scarpini
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Dino Ferrari Center, University of Milan, Milan, Italy
| | - Daniela Galimberti
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Dino Ferrari Center, University of Milan, Milan, Italy
| | -
- Netherlands Institute for Neuroscience, Amsterdam, The Netherlands
| | - Jeroen J M Hoozemans
- Department of Pathology, Amsterdam University Medical Centers, Location VUmc, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Yolande A L Pijnenburg
- Department of Neurology, Amsterdam University Medical Centers, Location VUmc, Alzheimer Center, Amsterdam, The Netherlands
| | - Anke A Dijkstra
- Department of Pathology, Amsterdam University Medical Centers, Location VUmc, Amsterdam Neuroscience, Amsterdam, The Netherlands
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27
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Turcano P, Stang CD, Mielke MM, Martin PR, Upadhyaya SG, Josephs KA, Boeve BF, Knopman DS, Petersen RC, Savica R. Incidence of frontotemporal disorders in Olmsted County: A population-based study. Alzheimers Dement 2020; 16:482-490. [PMID: 31784373 DOI: 10.1016/j.jalz.2019.08.199] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Frontotemporal dementia disorders (FTDs) are heterogeneous phenotypical behavioral and language disorders usually associated with frontal and/or temporal lobe degeneration. We investigated their incidence in a population-based cohort. METHODS Using a records-linkage system, we identified all patients with a diagnostic code for dementia in Olmsted County, MN, 1995-2010, and confirmed the diagnosis of FTD. A behavioral neurologist verified the clinical diagnosis and determined phenotypes. RESULTS We identified 35 FTDs cases. Overall, the incidence of FTDs was 4.3/100,000/year (95% CI: 2.9, 5.7). Incidence was higher in men (6.3/100,000, 95% CI 3.6, 9.0) than women (2.9/100,000; 95% CI: 1.3, 4.5); we observed an increased trend over time (B = 0.83, 95% CI: 0.54, 1.11, P < .001). At autopsy, clinical diagnosis was confirmed in eight (72.7%) cases. DISCUSSION We observed an increased incidence and trends of FTDs over time. This may reflect a better recognition by clinicians and improvement of clinical criteria and diagnostic tools.
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Affiliation(s)
| | - Cole D Stang
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Michelle M Mielke
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Peter R Martin
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | | | | | | | | | | | - Rodolfo Savica
- Department of Neurology, Mayo Clinic, Rochester, MN, USA.,Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
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28
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Abstract
PURPOSE OF REVIEW This article describes the clinical, anatomic, genetic, and pathologic features of behavioral variant frontotemporal dementia (bvFTD) and discusses strategies to improve diagnostic accuracy, emphasizing common pitfalls to avoid. Key aspects of management and the future of diagnosis and care for the disorder are highlighted. RECENT FINDINGS BvFTD is a clinical syndrome, not a disease. Patients with the syndrome share core symptoms that reflect degeneration within the most consistently affected brain regions, but accompanying features vary and reflect the precise topography of regional degeneration. The clinician must distinguish a bvFTD syndrome from psychiatric illness and other neurodegenerative syndromes that feature a prominent behavioral component. Antemortem prediction of pathologic diagnosis remains imperfect but improves with careful attention to the clinical details. Management should emphasize prevention of caregiver distress, behavioral and environmental strategies, symptom-based psychopharmacology, and genetic counseling. SUMMARY BvFTD is an important and challenging dementia syndrome. Although disease-modifying treatments are lacking, clinicians can have a profound impact on a family coping with this disorder. Treatment trials are under way for some genetic forms of bvFTD. For sporadic disease, pathologic heterogeneity remains a major challenge, and ongoing research seeks to improve antemortem molecular diagnosis to facilitate therapeutic discovery.
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29
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Boxer AL, Gold M, Feldman H, Boeve BF, Dickinson SLJ, Fillit H, Ho C, Paul R, Pearlman R, Sutherland M, Verma A, Arneric SP, Alexander BM, Dickerson BC, Dorsey ER, Grossman M, Huey ED, Irizarry MC, Marks WJ, Masellis M, McFarland F, Niehoff D, Onyike CU, Paganoni S, Panzara MA, Rockwood K, Rohrer JD, Rosen H, Schuck RN, Soares HD, Tatton N. New directions in clinical trials for frontotemporal lobar degeneration: Methods and outcome measures. Alzheimers Dement 2020; 16:131-143. [PMID: 31668596 PMCID: PMC6949386 DOI: 10.1016/j.jalz.2019.06.4956] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Frontotemporal lobar degeneration (FTLD) is the most common form of dementia for those under 60 years of age. Increasing numbers of therapeutics targeting FTLD syndromes are being developed. METHODS In March 2018, the Association for Frontotemporal Degeneration convened the Frontotemporal Degeneration Study Group meeting in Washington, DC, to discuss advances in the clinical science of FTLD. RESULTS Challenges exist for conducting clinical trials in FTLD. Two of the greatest challenges are (1) the heterogeneity of FTLD syndromes leading to difficulties in efficiently measuring treatment effects and (2) the rarity of FTLD disorders leading to recruitment challenges. DISCUSSION New personalized endpoints that are clinically meaningful to individuals and their families should be developed. Personalized approaches to analyzing MRI data, development of new fluid biomarkers and wearable technologies will help to improve the power to detect treatment effects in FTLD clinical trials and enable new, clinical trial designs, possibly leveraged from the experience of oncology trials. A computational visualization and analysis platform that can support novel analyses of combined clinical, genetic, imaging, biomarker data with other novel modalities will be critical to the success of these endeavors.
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Affiliation(s)
- Adam L. Boxer
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, CA
| | | | - Howard Feldman
- Department of Neurosciences, University of California San Diego, San Diego, CA
| | | | | | | | - Carole Ho
- Denali Therapeutics, San Francisco, CA
| | | | | | | | | | | | | | | | - Earl Ray Dorsey
- Center for Health and Technology, University of Rochester, Rochester, NY
| | - Murray Grossman
- Department of Neurology, University of Pennsylvania, Philadelphia, PA
| | - Edward D. Huey
- Departments of Psychiatry and Neurology, Columbia University, NY
| | | | - William J. Marks
- Clinical Neurology, Verily Life Sciences, South San Francisco, CA
| | - Mario Masellis
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, University of Toronto, ON, Canada; Department of Medicine (Neurology), Sunnybrook Health Sciences Centre, University of Toronto, ON, Canada
| | | | - Debra Niehoff
- Association for Frontotemporal Degeneration, Radnor, PA
| | - Chiadi U. Onyike
- Department Geriatric Psychiatry and Neuropsychiatry, Johns Hopkins University, Baltimore, MD
| | - Sabrina Paganoni
- Healey Center for ALS, Massachusetts General Hospital, Boston, MA
| | | | - Kenneth Rockwood
- Division of Geriatric Medicine, Dalhousie University, Halifax, NS
| | - Jonathan D. Rohrer
- Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, UK
| | - Howard Rosen
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, CA
| | - Robert N. Schuck
- Office of Clinical Pharmacology, Center for Drug Evaluation and Research, FDA, Silver Spring, MD
| | | | - Nadine Tatton
- Association for Frontotemporal Degeneration, Radnor, PA
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30
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Effects of Exercise on Long-Term Potentiation in Neuropsychiatric Disorders. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1228:439-451. [PMID: 32342476 DOI: 10.1007/978-981-15-1792-1_30] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Various neuropsychiatric conditions, such as depression, Alzheimer's disease, and Parkinson's disease, demonstrate evidence of impaired long-term potentiation, a cellular correlate of episodic memory function. This chapter discusses the mechanistic effects of these neuropsychiatric conditions on long-term potentiation and how exercise may help to attenuate these detrimental effects.
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31
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Rosen HJ, Boeve BF, Boxer AL. Tracking disease progression in familial and sporadic frontotemporal lobar degeneration: Recent findings from ARTFL and LEFFTDS. Alzheimers Dement 2020; 16:71-78. [PMID: 31914219 PMCID: PMC6953606 DOI: 10.1002/alz.12004] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 10/17/2019] [Accepted: 10/31/2019] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Familial frontotemporal lobar degeneration (f-FTLD) due to autosomal dominant mutations is an important entity for developing treatments for FTLD. The Advancing Research and Treatment for Frontotemporal Lobar Degeneration (ARTFL) and Longitudinal Evaluation of Familial Frontotemporal Dementia Subjects (LEFFTDS) longitudinal studies were designed to describe the natural history of f-FTLD. METHODS We summarized recent publications from the ARTFL and LEFFTDS studies, along with other recent publications describing the natural history of f-FTLD. RESULTS Published and emerging studies are producing data on all phases of f-FTLD, including the asymptomatic and symptomatic phases of disease, as well as the transitional phase when symptoms are just beginning to develop. These data indicate that rates of change increase along with disease severity, which is consistent with commonly cited models of neurodegeneration, and that measurement of biomarkers may predict onset of symptoms. DISCUSSION Data from large multisite studies are producing important data on the natural history of f-FTLD that will be critical for planning intervention trials.
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Affiliation(s)
- Howard J. Rosen
- Department of NeurologyMemory and Aging CenterUniversity of California, San FranciscoSan FranciscoCalifornia
| | | | - Adam L. Boxer
- Department of NeurologyMemory and Aging CenterUniversity of California, San FranciscoSan FranciscoCalifornia
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Staffaroni AM, Cobigo Y, Goh SYM, Kornak J, Bajorek L, Chiang K, Appleby B, Bove J, Bordelon Y, Brannelly P, Brushaber D, Caso C, Coppola G, Dever R, Dheel C, Dickerson BC, Dickinson S, Dominguez S, Domoto-Reilly K, Faber K, Ferrall J, Fields JA, Fishman A, Fong J, Foroud T, Forsberg LK, Gavrilova R, Gearhart D, Ghazanfari B, Ghoshal N, Goldman J, Graff-Radford J, Graff-Radford N, Grant I, Grossman M, Haley D, Heuer HW, Hsiung GY, Huey ED, Irwin DJ, Jones DT, Jones L, Kantarci K, Karydas A, Kaufer DI, Kerwin DR, Knopman DS, Kraft R, Kramer JH, Kremers WK, Kukull WA, Litvan I, Ljubenkov PA, Lucente D, Lungu C, Mackenzie IR, Maldonado M, Manoochehri M, McGinnis SM, McKinley E, Mendez MF, Miller BL, Multani N, Onyike C, Padmanabhan J, Pantelyat A, Pearlman R, Petrucelli L, Potter M, Rademakers R, Ramos EM, Rankin KP, Rascovsky K, Roberson ED, Rogalski E, Sengdy P, Shaw LM, Syrjanen J, Tartaglia MC, Tatton N, Taylor J, Toga A, Trojanowski JQ, Weintraub S, Wang P, Wong B, Wszolek Z, Boxer AL, Boeve BF, Rosen HJ. Individualized atrophy scores predict dementia onset in familial frontotemporal lobar degeneration. Alzheimers Dement 2020; 16:37-48. [PMID: 31272932 PMCID: PMC6938544 DOI: 10.1016/j.jalz.2019.04.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Some models of therapy for neurodegenerative diseases envision starting treatment before symptoms develop. Demonstrating that such treatments are effective requires accurate knowledge of when symptoms would have started without treatment. Familial frontotemporal lobar degeneration offers a unique opportunity to develop predictors of symptom onset. METHODS We created dementia risk scores in 268 familial frontotemporal lobar degeneration family members by entering covariate-adjusted standardized estimates of brain atrophy into a logistic regression to classify asymptomatic versus demented participants. The score's predictive value was tested in a separate group who were followed up longitudinally (stable vs. converted to dementia) using Cox proportional regressions with dementia risk score as the predictor. RESULTS Cross-validated logistic regression achieved good separation of asymptomatic versus demented (accuracy = 90%, SE = 0.06). Atrophy scores predicted conversion from asymptomatic or mildly/questionably symptomatic to dementia (HR = 1.51, 95% CI: [1.16,1.98]). DISCUSSION Individualized quantification of baseline brain atrophy is a promising predictor of progression in asymptomatic familial frontotemporal lobar degeneration mutation carriers.
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Affiliation(s)
- Adam M. Staffaroni
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Yann Cobigo
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Sheng-Yang M. Goh
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - John Kornak
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco CA, USA
| | - Lynn Bajorek
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Kevin Chiang
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Brian Appleby
- Department of Neurology, Case Western Reserve University, Cleveland, OH, USA
| | - Jessica Bove
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Yvette Bordelon
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Patrick Brannelly
- Tau Consortium, Rainwater Charitable Foundation, Fort Worth, TX, USA
| | | | - Christina Caso
- Department of Neurology, University of Washington, Seattle, WA, USA
| | - Giovanni Coppola
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Reilly Dever
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | | | - Bradford C. Dickerson
- Department of Neurology, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Susan Dickinson
- Association for Frontotemporal Degeneration, Radnor, PA, USA
| | - Sophia Dominguez
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Kelly Faber
- National Cell Repository for Alzheimer’s Disease (NCRAD), Indiana University, Indianapolis, IN, USA
| | - Jessica Ferrall
- Department of Neurology, University of North Carolina, Chapel Hill, NC, USA
| | - Julie A. Fields
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Ann Fishman
- Department of Psychiatry, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Jamie Fong
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Tatiana Foroud
- National Cell Repository for Alzheimer’s Disease (NCRAD), Indiana University, Indianapolis, IN, USA
| | | | | | - Debra Gearhart
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Behnaz Ghazanfari
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Nupur Ghoshal
- Departments of Neurology and Psychiatry, Washington University School of Medicine, Washington University, St. Louis, MO, USA
| | - Jill Goldman
- Department of Neurology, Columbia University, New York, NY, USA
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY, USA
| | | | | | - Ian Grant
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Murray Grossman
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Dana Haley
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - Hilary W. Heuer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Ging-Yuek Hsiung
- Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Edward D. Huey
- Department of Neurology, Columbia University, New York, NY, USA
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY, USA
| | - David J. Irwin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - David T. Jones
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Lynne Jones
- Department of Radiology, Washington University School of Medicine, Washington University, St. Louis, MO, USA
| | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Anna Karydas
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Daniel I. Kaufer
- Department of Neurology, University of North Carolina, Chapel Hill, NC, USA
| | - Diana R. Kerwin
- Department of Neurology and Neurotherapeutics, Center for Alzheimer’s and Neurodegenerative Diseases, The University of Texas, Southwestern Medical Center at Dallas, Dallas, TX, USA
- Department of Internal Medicine, The University of Texas, Southwestern Medical Center at Dallas, Dallas, TX, USA
| | | | - Ruth Kraft
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Joel H. Kramer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Walter K. Kremers
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Walter A. Kukull
- National Alzheimer Coordinating Center (NACC), University of Washington, Seattle, WA, USA
| | - Irene Litvan
- Department of Neurosciences, Parkinson and Other Movement Disorders Center, University of California, San Diego, San Diego, CA, USA
| | - Peter A. Ljubenkov
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Diane Lucente
- Department of Neurology, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Codrin Lungu
- National Institute of Neurological Disorders and Stroke (NINDS), Bethesda, MD, USA
| | - Ian R. Mackenzie
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Miranda Maldonado
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - Scott M. McGinnis
- Department of Neurology, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Emily McKinley
- Department of Neurology, Alzheimer’s Disease Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mario F. Mendez
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Bruce L. Miller
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Namita Multani
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Chiadi Onyike
- Department of Geriatric Psychiatry and Neuropsychiatry, Johns Hopkins University, Baltimore, MD, USA
| | - Jaya Padmanabhan
- Department of Neurology, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Alex Pantelyat
- Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | | | - Len Petrucelli
- Department of Neurosciences, Mayo Clinic, Jacksonville, FL, USA
| | - Madeline Potter
- National Cell Repository for Alzheimer’s Disease (NCRAD), Indiana University, Indianapolis, IN, USA
| | - Rosa Rademakers
- Department of Neurosciences, Mayo Clinic, Jacksonville, FL, USA
| | - Eliana Marisa Ramos
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Katherine P. Rankin
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Katya Rascovsky
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Erik D. Roberson
- Department of Neurology, Alzheimer’s Disease Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Emily Rogalski
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Pheth Sengdy
- Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Leslie M. Shaw
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jeremy Syrjanen
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - M. Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Nadine Tatton
- Association for Frontotemporal Degeneration, Radnor, PA, USA
| | - Joanne Taylor
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Arthur Toga
- Departments of Ophthalmology, Neurology, Psychiatry and the Behavioral Sciences, Radiology and Engineering, Laboratory of Neuroimaging (LONI), USC, Los Angeles, CA, USA
| | - John Q. Trojanowski
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sandra Weintraub
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Ping Wang
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Bonnie Wong
- Department of Neurology, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Adam L. Boxer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Brad F. Boeve
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Howard J. Rosen
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
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Survival and life-expectancy in a young-onset dementia cohort with six years of follow-up: the NeedYD-study. Int Psychogeriatr 2019; 31:1781-1789. [PMID: 30915930 DOI: 10.1017/s1041610219000152] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The aim of this study was to investigate survival time and life-expectancy in people with young-onset dementia (YOD) and to examine the relationship with age, sex, dementia subtype and comorbidity. DESIGN, SETTING AND PARTICIPANTS Survival was examined in 198 participants in the Needs in Young-onset Dementia study, including participants with Alzheimer's dementia (AD), vascular dementia (VaD) and frontotemporal dementia (FTD). MEASURES The primary outcomes were survival time after symptom onset and after date of diagnosis. Cox proportional hazards models were used to explore the relationship between survival and age, sex, dementia subtype and comorbidity. Additionally, the impact on remaining life expectancy was explored. RESULTS During the six-year follow-up, 77 of the participants died (38.9%), 78 participants survived (39.4%) and 43 were lost to follow-up (21.7%). The mean survival time after symptom onset and diagnosis was 209 months (95% CI 185-233) and 120 months (95% CI 110-130) respectively. Participants with AD had a statistically significant shorter survival compared with VaD participants, both regarding survival after symptom onset (p = 0.047) as well as regarding survival after diagnosis (p = 0.049). Younger age at symptom onset or at diagnosis was associated with longer survival times. The remaining life expectancy, after diagnosis, was reduced with 51% for males and 59% for females compared to the life expectancy of the general population in the same age groups. CONCLUSION/IMPLICATIONS It is important to consider the dementia subtype when persons with YOD and their families are informed about the prognosis of survival. Our study suggests longer survival times compared to other studies on YOD, and survival is prolonged compared to studies on LOD. Younger age at symptom onset or at diagnosis was positively related to survival but diagnosis at younger ages, nevertheless, still diminishes life expectancy dramatically.
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Chandra SR, Viswanathan LG, Pai AR, Wahatule R, Alladi S. Syndromes of Rapidly Progressive Cognitive Decline-Our Experience. J Neurosci Rural Pract 2019; 8:S66-S71. [PMID: 28936074 PMCID: PMC5602264 DOI: 10.4103/jnrp.jnrp_100_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: Dementias are fairly slowly progressive degenerative diseases of brain for which treatment options are very less and carry a lot of burden on family and society. A small percentage of them are rapidly progressive and mostly carry a different course outcome. However, there are no definite criteria other than the time line for these patients. Aims: The aim of this was to identify and categorize the causes and course of rapidly progressive dementias seen in our center. Settings and Design: Patients who presented with rapid deterioration of cognitive functions within weeks to 1 year between 2011 and December 2016 were evaluated. Patients and Methods: All patients underwent all mandatory tests for dementia including brain imaging. Complete vasculitis workup, autoimmune encephalitis profile including Voltage Gated Potassium Channel, N-methyl-D-aspartic acid receptor, glutamic acid-decarboxylase, thyroid-peroxidase antibody, cerebrospinal fluid, and other special tests such as duodenal biopsy and paraneoplastic workup were done based on clinical indications. Results and Conclusions: Out of 144 patients 42 had immune-mediated encephalopathy, 18 had Creutzfeldt-Jakob disease, 3 had Vitamin B12 deficiency, 63 had infection with neurocysticercosis, 7 had tuberculosis, 2 had HIV, 1 had herpes simplex encephalitis, 1 had neurosyphilis, 1 Whipples disease, 1 had Subacute Sclerosing Panencephalitis, 1 had Mass lesion, 3 had Frontotemporal dementia, and 3 had small vessel disease. Good majority of these patients have infective and immune-mediated causes and less number belong to degenerative group. Therefore, caution is needed to look for treatable cause as it carries a different treatment options and outcome.
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Affiliation(s)
| | | | - Anupama Ramakanth Pai
- Department of Neuromicrobiology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Rahul Wahatule
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Suvarna Alladi
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Kiselica AM, Benge JF. Quantitative and qualitative features of executive dysfunction in frontotemporal and Alzheimer's dementia. APPLIED NEUROPSYCHOLOGY-ADULT 2019; 28:449-463. [PMID: 31424275 DOI: 10.1080/23279095.2019.1652175] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Behavioral variant fronto-temporal degeneration (bvFTD) is typically distinguished from Alzheimer's disease (AD) by early, prominent dysexecutive findings, in addition to other clinical features. However, differences in executive functioning between these groups are not consistently found. The current study sought to investigate quantitative and qualitative differences in executive functioning between those with bvFTD and AD in a large sample, while controlling for dementia severity and demographic variables. Secondary data analyses were completed on a subset of cases from the National Alzheimer's Coordinating Center collected from 36 Alzheimer's Disease Research Centers and consisting of 1,577 individuals with AD and 406 individuals with bvFTD. Groups were compared on 1) ability to complete three commonly administered executive tasks (letter fluency, Trail Making Test Part B [TMTB], and digits backward); 2) quantitative test performance; and 3) errors on these tasks. Findings suggested that individuals with bvFTD were less likely to complete letter fluency, χ2(2) = 178.62, p < .001, and number span tasks, χ2(1) = 11.49, p < .001), whereas individuals with AD were less likely to complete TMTB, χ2(2) = 460.38, p < .001. Individuals with bvFTD performed more poorly on letter fluency, F(1) = 28.06, p = .013, but there were not group differences in TMTB lines per second or number span backwards. Errors generally did not differentiate the diagnostic groups. In summary, there is substantial overlap in executive dysfunction between those with bvFTD and AD, though individuals with bvFTD tend to demonstrate worse letter fluency performance.
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Affiliation(s)
- Andrew M Kiselica
- Division of Neuropsychology, Baylor Scott and White Health, Dallas, TX, USA
| | - Jared F Benge
- Division of Neuropsychology, Baylor Scott and White Health, Dallas, TX, USA.,Plummer Movement Disorders Center, Baylor Scott and White Health, Dallas, TX, USA.,Texas A&M College of Medicine, Bryan, TX, USA
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Lansdall CJ, Coyle-Gilchrist ITS, Vázquez Rodríguez P, Wilcox A, Wehmann E, Robbins TW, Rowe JB. Prognostic importance of apathy in syndromes associated with frontotemporal lobar degeneration. Neurology 2019; 92:e1547-e1557. [PMID: 30842292 PMCID: PMC6448451 DOI: 10.1212/wnl.0000000000007249] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 11/21/2018] [Indexed: 12/12/2022] Open
Abstract
Objective To determine the influence of apathy, impulsivity, and behavioral change on survival in patients with frontotemporal dementia, progressive supranuclear palsy, and corticobasal syndrome. Methods We assessed 124 patients from the epidemiologic PiPPIN (Pick's Disease and Progressive Supranuclear Palsy, Prevalence and Incidence) study. Patients underwent detailed baseline cognitive and behavioral assessment focusing on apathy, impulsivity, and behavioral change. Logistic regression identified predictors of death within 2.5 years from assessment, including age, sex, diagnosis, cognition, and 8 neurobehavioral profiles derived from a principal component analysis of neuropsychological and behavioral measures. Results An apathetic neurobehavioral profile predicted death (Wald statistic = 8.119, p = 0.004, Exp(B) = 2.912, confidence interval = >1 [1.396–6.075]) and was elevated in all patient groups. This profile represented apathy, weighted strongly to carer reports from the Apathy Evaluation Scale, Neuropsychiatric Inventory, and Cambridge Behavioral Inventory. Age at assessment, sex, and global cognitive impairment were not significant predictors. Differences in mortality risk across diagnostic groups were accounted for by their neuropsychiatric and behavioral features. Conclusions The relationship between apathy and survival highlights the need to develop more effective and targeted measurement tools to improve its recognition and facilitate treatment. The prognostic importance of apathy suggests that neurobehavioral features might be useful to predict survival and stratify patients for interventional trials. Effective symptomatic interventions targeting the neurobiology of apathy might ultimately also improve prognosis.
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Affiliation(s)
- Claire J Lansdall
- From the Departments of Clinical Neurosciences (C.J.L., I.T.S.C.-G., P.V.R., A.W., E.W., J.B.R.) and Psychology (T.W.R.), and Behavioral and Clinical Neuroscience Institute (T.W.R., J.B.R.), University of Cambridge, UK; University Medical Centre Hamburg-Eppendorf (E.W.), University of Hamburg, Germany; and MRC Cognition and Brain Sciences Unit (J.B.R.), Cambridge, UK.
| | - Ian T S Coyle-Gilchrist
- From the Departments of Clinical Neurosciences (C.J.L., I.T.S.C.-G., P.V.R., A.W., E.W., J.B.R.) and Psychology (T.W.R.), and Behavioral and Clinical Neuroscience Institute (T.W.R., J.B.R.), University of Cambridge, UK; University Medical Centre Hamburg-Eppendorf (E.W.), University of Hamburg, Germany; and MRC Cognition and Brain Sciences Unit (J.B.R.), Cambridge, UK
| | - Patricia Vázquez Rodríguez
- From the Departments of Clinical Neurosciences (C.J.L., I.T.S.C.-G., P.V.R., A.W., E.W., J.B.R.) and Psychology (T.W.R.), and Behavioral and Clinical Neuroscience Institute (T.W.R., J.B.R.), University of Cambridge, UK; University Medical Centre Hamburg-Eppendorf (E.W.), University of Hamburg, Germany; and MRC Cognition and Brain Sciences Unit (J.B.R.), Cambridge, UK
| | - Alicia Wilcox
- From the Departments of Clinical Neurosciences (C.J.L., I.T.S.C.-G., P.V.R., A.W., E.W., J.B.R.) and Psychology (T.W.R.), and Behavioral and Clinical Neuroscience Institute (T.W.R., J.B.R.), University of Cambridge, UK; University Medical Centre Hamburg-Eppendorf (E.W.), University of Hamburg, Germany; and MRC Cognition and Brain Sciences Unit (J.B.R.), Cambridge, UK
| | - Eileen Wehmann
- From the Departments of Clinical Neurosciences (C.J.L., I.T.S.C.-G., P.V.R., A.W., E.W., J.B.R.) and Psychology (T.W.R.), and Behavioral and Clinical Neuroscience Institute (T.W.R., J.B.R.), University of Cambridge, UK; University Medical Centre Hamburg-Eppendorf (E.W.), University of Hamburg, Germany; and MRC Cognition and Brain Sciences Unit (J.B.R.), Cambridge, UK
| | - Trevor W Robbins
- From the Departments of Clinical Neurosciences (C.J.L., I.T.S.C.-G., P.V.R., A.W., E.W., J.B.R.) and Psychology (T.W.R.), and Behavioral and Clinical Neuroscience Institute (T.W.R., J.B.R.), University of Cambridge, UK; University Medical Centre Hamburg-Eppendorf (E.W.), University of Hamburg, Germany; and MRC Cognition and Brain Sciences Unit (J.B.R.), Cambridge, UK
| | - James B Rowe
- From the Departments of Clinical Neurosciences (C.J.L., I.T.S.C.-G., P.V.R., A.W., E.W., J.B.R.) and Psychology (T.W.R.), and Behavioral and Clinical Neuroscience Institute (T.W.R., J.B.R.), University of Cambridge, UK; University Medical Centre Hamburg-Eppendorf (E.W.), University of Hamburg, Germany; and MRC Cognition and Brain Sciences Unit (J.B.R.), Cambridge, UK
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Rogalski EJ, Sridhar J, Martersteck A, Rader B, Cobia D, Arora AK, Fought AJ, Bigio EH, Weintraub S, Mesulam MM, Rademaker A. Clinical and cortical decline in the aphasic variant of Alzheimer's disease. Alzheimers Dement 2019; 15:543-552. [PMID: 30765195 DOI: 10.1016/j.jalz.2018.12.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 10/18/2018] [Accepted: 12/02/2018] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Primary progressive aphasia (PPA) displays variable progression trajectories that require further elucidation. METHODS Longitudinal quantitation of atrophy and language over 12 months was completed for PPA patients with and without positive amyloid PET (PPAAβ+ and PPAAβ-), an imaging biomarker of underlying Alzheimer's disease. RESULTS Over 12 months, both PPA groups showed significantly greater cortical atrophy rates in the left versus right hemisphere, with a more widespread pattern in PPAAβ+. The PPAAβ+ group also showed greater decline in performance on most language tasks. There was no obligatory relationship between the logopenic PPA variant and amyloid status. Effect sizes from quantitative MRI data were more robust than neuropsychological metrics. DISCUSSION Preferential language network neurodegeneration is present in PPA irrespective of amyloid status. Clinical and anatomical progression appears to differ for PPA due to Alzheimer's disease versus non-Alzheimer's disease neuropathology, a distinction that may help to inform prognosis and the design of intervention trials.
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Affiliation(s)
- Emily Joy Rogalski
- Cognitive Neurology and Alzheimer's Disease Center, Northwestern University (NU) Feinberg School of Medicine, Chicago, IL, USA; NU Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, Chicago, IL, USA.
| | - Jaiashre Sridhar
- Cognitive Neurology and Alzheimer's Disease Center, Northwestern University (NU) Feinberg School of Medicine, Chicago, IL, USA
| | - Adam Martersteck
- Cognitive Neurology and Alzheimer's Disease Center, Northwestern University (NU) Feinberg School of Medicine, Chicago, IL, USA
| | - Benjamin Rader
- Cognitive Neurology and Alzheimer's Disease Center, Northwestern University (NU) Feinberg School of Medicine, Chicago, IL, USA
| | - Derin Cobia
- Department of Psychology, Brigham Young University, Provo, UT, USA
| | - Anupa K Arora
- Avid Radiopharmaceuticals Inc, Philadelphia, PA, USA
| | - Angela J Fought
- NU Feinberg School of Medicine, Department of Preventive Medicine, Chicago, IL, USA
| | - Eileen H Bigio
- NU Feinberg School of Medicine, Department of Pathology, Chicago, IL, USA
| | - Sandra Weintraub
- Cognitive Neurology and Alzheimer's Disease Center, Northwestern University (NU) Feinberg School of Medicine, Chicago, IL, USA; NU Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, Chicago, IL, USA
| | - Marek-Marsel Mesulam
- Cognitive Neurology and Alzheimer's Disease Center, Northwestern University (NU) Feinberg School of Medicine, Chicago, IL, USA; NU Feinberg School of Medicine, Department of Neurology, Chicago, IL, USA
| | - Alfred Rademaker
- NU Feinberg School of Medicine, Department of Preventive Medicine, Chicago, IL, USA
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Ge W, Jakobsson E. Systems Biology Understanding of the Effects of Lithium on Affective and Neurodegenerative Disorders. Front Neurosci 2018; 12:933. [PMID: 30618562 PMCID: PMC6300566 DOI: 10.3389/fnins.2018.00933] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 11/27/2018] [Indexed: 01/08/2023] Open
Abstract
Lithium has many widely varying biochemical and phenomenological effects, suggesting that a systems biology approach is required to understand its action. Multiple lines of evidence point to lithium intake and consequent blood levels as important determinants of incidence of neurodegenerative disease, showing that understanding lithium action is of high importance. In this paper we undertake first steps toward a systems approach by analyzing mutual enrichment between the interactomes of lithium-sensitive enzymes and the pathways associated with affective and neurodegenerative disorders. This work integrates information from two important databases, STRING and KEGG pathways. We find that for the majority of neurodegenerative disorders the mutual enrichment is many times greater than chance, reinforcing previous lines of evidence that lithium is an important influence on incidence of neurodegeneration. Our work suggests rational prioritization for which disorders are likely to be most sensitive to lithium and identifies genes that are likely to be useful targets for therapy adjunct to lithium.
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Affiliation(s)
- Weihao Ge
- National Center for Supercomputing Applications, Urbana-Champaign, Urbana, IL, United States
- Center for Biophysics and Computational Biology, Urbana-Champaign, Urbana, IL, United States
| | - Eric Jakobsson
- National Center for Supercomputing Applications, Urbana-Champaign, Urbana, IL, United States
- Center for Biophysics and Computational Biology, Urbana-Champaign, Urbana, IL, United States
- Department of Molecular and Integrative Physiology University of Illinois at Urbana-Champaign, Urbana, IL, United States
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Beagle AJ, Darwish SM, Ranasinghe KG, La AL, Karageorgiou E, Vossel KA. Relative Incidence of Seizures and Myoclonus in Alzheimer's Disease, Dementia with Lewy Bodies, and Frontotemporal Dementia. J Alzheimers Dis 2018; 60:211-223. [PMID: 28826176 DOI: 10.3233/jad-170031] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Patients with Alzheimer's disease (AD) are more prone to seizures and myoclonus, but relative risk of these symptoms among other dementia types is unknown. OBJECTIVE To determine incidence of seizures and myoclonus in the three most common neurodegenerative dementias: AD, dementia with Lewy bodies (DLB), and frontotemporal dementia (FTD). METHODS Our institution's medical records were reviewed for new-onset unprovoked seizures and myoclonus in patients meeting criteria for AD (n = 1,320), DLB (n = 178), and FTD (n = 348). Cumulative probabilities of developing seizures and myoclonus were compared between diagnostic groups, whereas age-stratified incidence rates were determined relative to control populations. RESULTS The cumulative probability of developing seizures after disease onset was 11.5% overall, highest in AD (13.4%) and DLB (14.7%) and lowest in FTD (3.0%). The cumulative probability of developing myoclonus was 42.1% overall, highest in DLB (58.1%). The seizure incidence rates, relative to control populations, were nearly 10-fold in AD and DLB, and 6-fold in FTD. Relative seizure rates increased with earlier age-at-onset in AD (age <50, 127-fold; 50-69, 21-fold; 70+, 2-fold) and FTD (age <50, 53-fold; 50-69, 9-fold), and relative myoclonus rates increased with earlier age-at-onset in all groups. Seizures began an average of 3.9 years after the onset of cognitive or motor decline, and myoclonus began 5.4 years after onset. CONCLUSIONS Seizures and myoclonus occur with greater incidence in patients with AD, DLB, and FTD than in the general population, but rates vary with diagnosis, suggesting varied pathomechanisms of network hyperexcitability. Patients often experience these symptoms early in disease, suggesting hyperexcitability could be an important target for interventions.
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Affiliation(s)
- Alexander J Beagle
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, USA
| | - Sonja M Darwish
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, USA
| | - Kamalini G Ranasinghe
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, USA
| | - Alice L La
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, USA
| | - Elissaios Karageorgiou
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, USA.,Neurological Institute of Athens, Athens, Greece
| | - Keith A Vossel
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, USA.,N. Bud Grossman Center for Memory Research and Care, Institute for Translational Neuroscience, and Department of Neurology, University of Minnesota, Minneapolis, MN, USA
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40
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Abstract
Alzheimer's disease (AD) is a debilitating disease influencing a multitude of outcomes, including memory function. Recent work suggests that memory may be influenced by exercise ('memorcise'), even among those with AD. The present narrative review details (1) the underlying mechanisms of AD; (2) whether exercise has a protective effect in preventing AD; (3) the mechanisms through which exercise may help to prevent AD; (4) the mechanisms through which exercise may help attenuate the progression of AD severity among those with existing AD; (5) the effects and mechanisms through which exercise is associated with memory among those with existing AD; and (6) exercise recommendations for those with existing AD. Such an understanding will aid clinicians in their ability to use exercise as a potential behavioral strategy to help prevent and treat AD.
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Affiliation(s)
- Paul D Loprinzi
- a Physical Activity Epidemiology Laboratory, Exercise Psychology Laboratory, Department of Health, Exercise Science and Recreation Management , The University of Mississippi , University , MS , USA
| | - Emily Frith
- a Physical Activity Epidemiology Laboratory, Exercise Psychology Laboratory, Department of Health, Exercise Science and Recreation Management , The University of Mississippi , University , MS , USA
| | - Pamela Ponce
- a Physical Activity Epidemiology Laboratory, Exercise Psychology Laboratory, Department of Health, Exercise Science and Recreation Management , The University of Mississippi , University , MS , USA
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41
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Matamoros-Angles A, Gayosso LM, Richaud-Patin Y, di Domenico A, Vergara C, Hervera A, Sousa A, Fernández-Borges N, Consiglio A, Gavín R, López de Maturana R, Ferrer I, López de Munain A, Raya Á, Castilla J, Sánchez-Pernaute R, Del Río JA. iPS Cell Cultures from a Gerstmann-Sträussler-Scheinker Patient with the Y218N PRNP Mutation Recapitulate tau Pathology. Mol Neurobiol 2018; 55:3033-3048. [PMID: 28466265 PMCID: PMC5842509 DOI: 10.1007/s12035-017-0506-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 03/21/2017] [Indexed: 01/20/2023]
Abstract
Gerstmann-Sträussler-Scheinker (GSS) syndrome is a fatal autosomal dominant neurodegenerative prionopathy clinically characterized by ataxia, spastic paraparesis, extrapyramidal signs and dementia. In some GSS familiar cases carrying point mutations in the PRNP gene, patients also showed comorbid tauopathy leading to mixed pathologies. In this study we developed an induced pluripotent stem (iPS) cell model derived from fibroblasts of a GSS patient harboring the Y218N PRNP mutation, as well as an age-matched healthy control. This particular PRNP mutation is unique with very few described cases. One of the cases presented neurofibrillary degeneration with relevant Tau hyperphosphorylation. Y218N iPS-derived cultures showed relevant astrogliosis, increased phospho-Tau, altered microtubule-associated transport and cell death. However, they failed to generate proteinase K-resistant prion. In this study we set out to test, for the first time, whether iPS cell-derived neurons could be used to investigate the appearance of disease-related phenotypes (i.e, tauopathy) identified in the GSS patient.
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Affiliation(s)
- Andreu Matamoros-Angles
- Institute for Bioengineering of Catalonia (IBEC), Parc Científic de Barcelona, Baldiri Reixac 15-21, E-08028, Barcelona, Spain
- Department of Cell Biology, Physiology and Immunology, Universitat de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
- Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - Lucía Mayela Gayosso
- Stem cells and neural repair laboratory, Fundación Inbiomed, San Sebastian, Gipuzkoa, Spain
- Proteomics unit (Prion lab), CIC bioGUNE, Parque tecnológico de Bizkaia, 48160, Derio, Bizkaia, Spain
- IKERBASQUE, Basque Foundation for Science, Bilbao, Bizkaia, Spain
| | - Yvonne Richaud-Patin
- Centre de Medicina Regenerativa de Barcelona, c/ Dr. Aiguader 88, 08003, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBERBBN), Madrid, Spain
| | - Angelique di Domenico
- Institut de Biomedicina de la Universitat de Barcelona, Barcelona, Spain
- Dept. Patologia i Terapèutica Experimental, Universitat de Barcelona, Barcelona, Spain
| | - Cristina Vergara
- Institute for Bioengineering of Catalonia (IBEC), Parc Científic de Barcelona, Baldiri Reixac 15-21, E-08028, Barcelona, Spain
- Department of Cell Biology, Physiology and Immunology, Universitat de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
- Institute of Neuroscience, University of Barcelona, Barcelona, Spain
- Laboratory of Histology, Neuroanatomy and Neuropathology (CP 620), ULB Neuroscience Institute. Université Libre de Bruxelles, Faculty of Medicine, Brussels, Belgium
| | - Arnau Hervera
- Institute for Bioengineering of Catalonia (IBEC), Parc Científic de Barcelona, Baldiri Reixac 15-21, E-08028, Barcelona, Spain
- Department of Cell Biology, Physiology and Immunology, Universitat de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
- Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - Amaya Sousa
- Stem cells and neural repair laboratory, Fundación Inbiomed, San Sebastian, Gipuzkoa, Spain
| | - Natalia Fernández-Borges
- Proteomics unit (Prion lab), CIC bioGUNE, Parque tecnológico de Bizkaia, 48160, Derio, Bizkaia, Spain
- IKERBASQUE, Basque Foundation for Science, Bilbao, Bizkaia, Spain
- CISA-INIA, Center for Animal Health Research, Madrid, Spain
| | - Antonella Consiglio
- Institut de Biomedicina de la Universitat de Barcelona, Barcelona, Spain
- Dept. Patologia i Terapèutica Experimental, Universitat de Barcelona, Barcelona, Spain
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Rosalina Gavín
- Institute for Bioengineering of Catalonia (IBEC), Parc Científic de Barcelona, Baldiri Reixac 15-21, E-08028, Barcelona, Spain
- Department of Cell Biology, Physiology and Immunology, Universitat de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
- Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | | | - Isidro Ferrer
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
- Institute of Neuroscience, University of Barcelona, Barcelona, Spain
- Dept. Patologia i Terapèutica Experimental, Universitat de Barcelona, Barcelona, Spain
| | - Adolfo López de Munain
- Instituto Biodonostia-Hospital Universitario Donostia, San Sebastian, Gipuzkoa, Spain
- Neurosciences Department, University of the Basque Country UPV-EHU, Bilbao, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), San Sebastian, Gipuzkoa, Spain
| | - Ángel Raya
- Centre de Medicina Regenerativa de Barcelona, c/ Dr. Aiguader 88, 08003, Barcelona, Spain.
- Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBERBBN), Madrid, Spain.
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain.
| | - Joaquín Castilla
- Proteomics unit (Prion lab), CIC bioGUNE, Parque tecnológico de Bizkaia, 48160, Derio, Bizkaia, Spain.
- IKERBASQUE, Basque Foundation for Science, Bilbao, Bizkaia, Spain.
| | - Rosario Sánchez-Pernaute
- Stem cells and neural repair laboratory, Fundación Inbiomed, San Sebastian, Gipuzkoa, Spain.
- Andalusian Initiative for Advanced Therapies, Junta de Andalusia, Seville, Spain.
| | - José Antonio Del Río
- Institute for Bioengineering of Catalonia (IBEC), Parc Científic de Barcelona, Baldiri Reixac 15-21, E-08028, Barcelona, Spain.
- Department of Cell Biology, Physiology and Immunology, Universitat de Barcelona, Barcelona, Spain.
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain.
- Institute of Neuroscience, University of Barcelona, Barcelona, Spain.
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42
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Sun Y, Chan KCG, Qin J. Simple and fast overidentified rank estimation for right-censored length-biased data and backward recurrence time. Biometrics 2018; 74:77-85. [PMID: 28504836 PMCID: PMC5976459 DOI: 10.1111/biom.12727] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 04/01/2017] [Accepted: 04/01/2017] [Indexed: 11/25/2022]
Abstract
Length-biased survival data subject to right-censoring are often collected from a prevalent cohort. However, informative right censoring induced by the sampling design creates challenges in methodological development. While certain conditioning arguments could circumvent the problem of informative censoring, related rank estimation methods are typically inefficient because the marginal likelihood of the backward recurrence time is not ancillary. Under a semiparametric accelerated failure time model, an overidentified set of log-rank estimating equations is constructed based on the left-truncated right-censored data and backward recurrence time. Efficient combination of the estimating equations is simplified by exploiting an asymptotic independence property between two sets of estimating equations. A fast algorithm is studied for solving non-smooth, non-monotone estimating equations. Simulation studies confirm that the overidentified rank estimator can have a substantially improved estimation efficiency compared to just-identified rank estimators. The proposed method is applied to a dementia study for illustration.
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Affiliation(s)
- Yifei Sun
- Department of Biostatistics, Johns Hopkins University, Baltimore, Maryland 21205, U.S.A
| | - Kwun Chuen Gary Chan
- Department of Biostatistics, University of Washington, Seattle, Washington 98195, U.S.A
| | - Jing Qin
- Biostatistics Research Branch, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland 20892, U.S.A
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43
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Martins LT, Teixeira IA, Laks J, Marinho V. Recognizing Late Onset Frontotemporal Dementia with the DAPHNE scale: A case report. Dement Neuropsychol 2018; 12:75-79. [PMID: 29682237 PMCID: PMC5901253 DOI: 10.1590/1980-57642018dn12-010011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Frontotemporal dementias are classically described as early onset dementias with personality and behavioral changes, however, late onset forms can also be found. Considering the paucity of information about late onset behavioral variant frontotemporal dementia and its challenging diagnosis, we present a case report of an 85-year-old woman with behavioral changes and slow progression to dementia who was first diagnosed as having bipolar disorder and then Alzheimer's disease. The Daphne scale provided a structured means to improve clinical diagnosis, also supported by characteristic features on MRI and SPECT, while CSF biomarkers ruled out atypical Alzheimer's disease.
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Affiliation(s)
- Leonardo Tafarello Martins
- Center for Alzheimer's disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, RJ, Brazil
| | - Ivan Abdalla Teixeira
- Center for Alzheimer's disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, RJ, Brazil.,MSc Student Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, RJ, Brazil
| | - Jerson Laks
- Center for Alzheimer's disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, RJ, Brazil.,Associate Professor, Universidade do Estado do Rio de Janeiro, RJ, Brazil.,Invited Professor, Postgraduate Program in Translational Biomedicine, Universidade do Grande Rio (Biotrans - Unigranrio)
| | - Valeska Marinho
- Center for Alzheimer's disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, RJ, Brazil.,PhD. Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, RJ, Brazil
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44
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Takano Y, Kunitoki K, Tatewaki Y, Mutoh T, Totsune T, Shimomura H, Nakagawa M, Arai H, Taki Y. Posterior Associative and Cingulate Cortex Involvement of Brain Single-Photon Emission Computed Tomography (SPECT) Imaging in Semantic Dementia with Probable Alzheimer Disease Pathology: A Case Report. AMERICAN JOURNAL OF CASE REPORTS 2018; 19:153-157. [PMID: 29429985 PMCID: PMC5817968 DOI: 10.12659/ajcr.907799] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Patient: Male, 61 Final Diagnosis: Semantic dementia Symptoms: Primary progressive aphasia Medication: — Clinical Procedure: Neuroimaging Specialty: Nuclear Medicine
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Affiliation(s)
- Yumi Takano
- Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan.,Department of Geriatric Medicine and Neuroimaging, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Keiko Kunitoki
- Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan.,Department of Geriatric Medicine and Neuroimaging, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Yasuko Tatewaki
- Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan.,Department of Geriatric Medicine and Neuroimaging, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Tatsushi Mutoh
- Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan.,Department of Geriatric Medicine and Neuroimaging, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Tomoko Totsune
- Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan.,Department of Geriatric Medicine and Neuroimaging, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Hideo Shimomura
- Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku Univerisity, Sendai, Miyagi, Japan.,Department of Geriatric Medicine and Neuroimaging, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Manabu Nakagawa
- Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan.,Department of Geriatric Medicine and Neuroimaging, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Hiroyuki Arai
- Department of Geriatric Medicine and Neuroimaging, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Yasuyuki Taki
- Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan.,Department of Geriatric Medicine and Neuroimaging, Tohoku University Hospital, Sendai, Miyagi, Japan
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45
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Verstaen A, Moskowitz JT, Snowberg KE, Merrilees J, Dowling GA. Life Enhancing Activities for Family Caregivers of people with dementia: protocol for a randomized controlled trial of a positive affect skills intervention. OPEN ACCESS JOURNAL OF CLINICAL TRIALS 2018; 10:1-12. [PMID: 33981167 PMCID: PMC8112203 DOI: 10.2147/oajct.s150597] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Given the increasing number of family caregivers of persons with dementia (PWD) and the associated burden and detriments to both physical and mental health, interventions that aim to improve such outcomes are important. Studies are increasingly demonstrating the unique importance of positive emotions in coping with stress, independent from the impact of negative emotions. However, none have examined the benefits of interventions that target positive emotions for caregivers of individuals with a chronic and debilitating disease such as dementia. This paper presents the design and methods for a randomized controlled trial (RCT) of a positive affect skills intervention for family caregivers of PWD. The RCT is of a skills-based intervention that seeks to increase the frequency and intensity of positive affect in order to improve outcomes such as well-being, coping, and physical and mental health. The skills are delivered by trained facilitators via five one-to-one Internet video sessions with family caregivers of persons diagnosed with dementia (eg, Alzheimer's disease, vascular dementia, unspecified). The control group is an emotion reporting/waitlist control. Follow-up assessments are conducted post-intervention and at 1, 3, and 6 months post-completion of the intervention. This study promises to be an important and needed step toward improving the lives of caregivers of PWD.
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Affiliation(s)
- Alice Verstaen
- Department of Physiological Nursing, University of California, San Francisco, San Francisco, CA
| | - Judith T Moskowitz
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Karin E Snowberg
- Department of Physiological Nursing, University of California, San Francisco, San Francisco, CA
| | - Jennifer Merrilees
- UCSF Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Glenna A Dowling
- Department of Physiological Nursing, University of California, San Francisco, San Francisco, CA
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46
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Abstract
Frontotemporal dementia (FTD) is a neurodegenerative disorder characterized by progressive changes in behavior, personality, and language with involvement of the frontal and temporal regions of the brain. About 40% of FTD cases have a positive family history, and about 10% of these cases are inherited in an autosomal-dominant pattern. These gene defects present with distinct clinical phenotypes. As the diagnosis of FTD becomes more recognizable, it will become increasingly important to keep these gene mutations in mind. In this chapter, we review the genes with known associations to FTD. We discuss protein functions, mutation frequencies, clinical phenotypes, imaging characteristics, and pathology associated with these genes.
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Affiliation(s)
- Jessica Deleon
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, United States
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, United States.
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47
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Fumagalli GG. Diagnosis of Frontotemporal Dementia. NEURODEGENER DIS 2018. [DOI: 10.1007/978-3-319-72938-1_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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48
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Cosseddu M, Benussi A, Gazzina S, Turrone R, Archetti S, Bonomi E, Biasiotto G, Zanella I, Ferrari R, Cotelli MS, Alberici A, Padovani A, Borroni B. Mendelian forms of disease and age at onset affect survival in frontotemporal dementia. Amyotroph Lateral Scler Frontotemporal Degener 2017; 19:87-92. [DOI: 10.1080/21678421.2017.1384020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Maura Cosseddu
- Neurology Unit, Spedali Civili Hospital, Brescia, Italy,
| | - Alberto Benussi
- Centre for Ageing Brain and Neurodegenerative Disorders, Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy,
| | - Stefano Gazzina
- Centre for Ageing Brain and Neurodegenerative Disorders, Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy,
| | - Rosanna Turrone
- Centre for Ageing Brain and Neurodegenerative Disorders, Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy,
| | - Silvana Archetti
- Biotechnology Laboratory and Department of Diagnostics, Civic Hospital of Brescia, Brescia, Italy,
| | - Elisa Bonomi
- Centre for Ageing Brain and Neurodegenerative Disorders, Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy,
| | - Giorgio Biasiotto
- Biotechnology Laboratory and Department of Diagnostics, Civic Hospital of Brescia, Brescia, Italy,
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy,
| | - Isabella Zanella
- Biotechnology Laboratory and Department of Diagnostics, Civic Hospital of Brescia, Brescia, Italy,
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy,
| | - Raffaele Ferrari
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK, and
| | | | - Antonella Alberici
- Centre for Ageing Brain and Neurodegenerative Disorders, Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy,
| | - Alessandro Padovani
- Centre for Ageing Brain and Neurodegenerative Disorders, Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy,
| | - Barbara Borroni
- Centre for Ageing Brain and Neurodegenerative Disorders, Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy,
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49
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Couratier P, Corcia P, Lautrette G, Nicol M, Marin B. ALS and frontotemporal dementia belong to a common disease spectrum. Rev Neurol (Paris) 2017; 173:273-279. [DOI: 10.1016/j.neurol.2017.04.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 04/05/2017] [Indexed: 12/13/2022]
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50
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Binney RJ, Pankov A, Marx G, He X, McKenna F, Staffaroni AM, Kornak J, Attygalle S, Boxer AL, Schuff N, Gorno‐Tempini M, Weiner MW, Kramer JH, Miller BL, Rosen HJ. Data-driven regions of interest for longitudinal change in three variants of frontotemporal lobar degeneration. Brain Behav 2017; 7:e00675. [PMID: 28413716 PMCID: PMC5390848 DOI: 10.1002/brb3.675] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 02/04/2017] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Longitudinal imaging of neurodegenerative disorders is a potentially powerful biomarker for use in clinical trials. In Alzheimer's disease, studies have demonstrated that empirically derived regions of interest (ROIs) can provide more reliable measurement of disease progression compared with anatomically defined ROIs. METHODS We set out to derive ROIs with optimal effect size for quantifying longitudinal change in a hypothetical clinical trial by comparing atrophy rates in 44 patients with behavioral variant of frontotemporal dementia (bvFTD), 30 with the semantic variant primary progressive aphasia (svPPA), and 26 with the nonfluent variant PPA (nfvPPA) to atrophy in 97 cognitively healthy controls. RESULTS The regions identified for each variant were generally what would be expected from prior studies of frontotemporal lobar degeneration (FTLD). Sample size estimates for detecting a 40% reduction in annual rate of ROI atrophy varied substantially across groups, being 103 per arm in bvFTD, 31 in nfvPPA, and 10 in svPPA, but in all groups were less than those estimated for a priori ROIs and clinical measures. The variability in location of peak regions of atrophy across individuals was highest in bvFTD and lowest in svPPA, likely relating to the differences in effect size. CONCLUSIONS These findings suggest that, while cross-validated maps of change can improve sensitivity to change in FTLD compared with a priori regions, the reliability of these maps differs considerably across syndromes. Future studies can utilize these maps to design clinical trials, and should try to identify factors accounting for the variability in patterns of atrophy across individuals, particularly those with bvFTD.
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Affiliation(s)
- Richard J. Binney
- Department of NeurologyMemory and Aging CenterUniversity of California, San FranciscoSan FranciscoCAUSA
| | - Aleksandr Pankov
- Department of Epidemiology and BiostatisticsUniversity of California, San FranciscoSan FranciscoCAUSA
- Department of Neurological SurgeryUniversity of California, San FranciscoSan FranciscoCAUSA
| | - Gabriel Marx
- Department of NeurologyMemory and Aging CenterUniversity of California, San FranciscoSan FranciscoCAUSA
| | - Xuanzie He
- Department of NeurologyMemory and Aging CenterUniversity of California, San FranciscoSan FranciscoCAUSA
| | - Faye McKenna
- Department of NeurologyMemory and Aging CenterUniversity of California, San FranciscoSan FranciscoCAUSA
| | - Adam M. Staffaroni
- Department of NeurologyMemory and Aging CenterUniversity of California, San FranciscoSan FranciscoCAUSA
| | - John Kornak
- Department of Epidemiology and BiostatisticsUniversity of California, San FranciscoSan FranciscoCAUSA
| | - Suneth Attygalle
- Department of NeurologyMemory and Aging CenterUniversity of California, San FranciscoSan FranciscoCAUSA
| | - Adam L. Boxer
- Department of NeurologyMemory and Aging CenterUniversity of California, San FranciscoSan FranciscoCAUSA
| | - Norbert Schuff
- Department of RadiologyUniversity of California, San FranciscoSan FranciscoCAUSA
| | - Maria‐Luisa Gorno‐Tempini
- Department of NeurologyMemory and Aging CenterUniversity of California, San FranciscoSan FranciscoCAUSA
| | - Michael W. Weiner
- Department of RadiologyUniversity of California, San FranciscoSan FranciscoCAUSA
| | - Joel H. Kramer
- Department of NeurologyMemory and Aging CenterUniversity of California, San FranciscoSan FranciscoCAUSA
| | - Bruce L. Miller
- Department of NeurologyMemory and Aging CenterUniversity of California, San FranciscoSan FranciscoCAUSA
| | - Howard J. Rosen
- Department of NeurologyMemory and Aging CenterUniversity of California, San FranciscoSan FranciscoCAUSA
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