Frontotemporal Dementia is as Common as Alzheimer’s

‘sFrontotemporal dementia (FTD) is a form of mental breakdown that affects decision-making, emotion, behavior, and language and it slowly destroys a person’s ability to react appropriately in a social setting. It affects the ability even carry out the most routine of daily activities.

Researchers at the University of California at San Francisco (UCSF) received a $10 million grant from the National Institutes of Health, co-funded mainly by the National Institute of Aging, and the National Institute of Neurological Disease and Stroke, to begin a study on frontotemporal dementia, a degenerative brain disease that is almost as common as Alzheimer’s in people under 60 years of age.

With this condition, behavior is severely changed, causing some patients to mishandle money, commit adultery, do some type of criminal activity (such as embezzlement), and all sorts of things that normally would be counter to their normal way of thinking.

There have been several mutated genes found to be associated with different forms of this disease, each of which can lead to destruction of nerve cells in the temporal and frontal lobes of the brain. There currently is are no treatments that target the proteins these genes produce, although there is a trial being conducted now through several different institutions to test a drug that works on the symptoms.

Associate professor of neurology at UCS, Howard Rosen, MD, a leads the study currently underway. Researchers are trying to find a way to track the changes in the brain as the disease progresses, using new imaging techniques. This will enable them to watch the impact experimental drugs have on the affected areas and identify biomarkers for diagnosis.

“Having accurate measures of the normal rates of change in FTD will be critical for planning future medication trials that will use imaging as an outcome,” says Rosen. He added that, “While cognitive testing scores vary from day to day due to factors such as sleep quality and medication use, imaging studies measure brain structure and function precisely. They can reveal when a drug has slowed or reversed the brain shrinkage that would normally occur.”

Scientists from the Mayo Clinic in Rochester, Minnesota have jointed the UCSF researchers. Together they are studying 120 FTD patients and 80 cognitively normal control subjects, following each participants over the course of 18 months through a series of brain imaging, neurological examinations, including behavioral and cognitive assessments. Leading the Mayo Clinic team is neurologist David Knopman, MD.

FTD patients are found through neurological, cognitive and behavioral evaluations. Blood tests and neuroimaging supplement the process, although they are primarily used to rule out other neurological disorders rather than reveal a definitive diagnosis.

Several different types of images will be taken of each subject, some by way of structural magnetic resonance imaging (measures the size and shape of the brain), and others by positron emission tomography (examines metabolism, such as glucose consumption). New MRI techniques that measure the blood content in the brain also be used, as well as a technique called diffusion tensor imaging that determines the integrity of the neural wiring, or axons, that connect to various parts of the brain.

“It is possible that one or both of these techniques could replace PET scanning, which is expensive and requires exposure to radiation,” says Rosen. “This would lower the cost of clinical trials and make it possible for more patients to enroll because MRI scanners are commonly available.”

The study will assess the chemical changes that occur in the blood and cerebrospinal fluid around the brain, and observe as to whether a combination of images, such as structural MRI, PET and DTI, will provide a better explanation of how a patient is doing than any one single imaging technique.

Results should be complete sometime in late 2012.

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About the author:

Ron White is a two-time U.S.A. Memory Champion


Master Minds – Memory Aging: Major Imaging Initiative to Shed Light on Little Known Brain Disease:

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