Improved detection of frontotemporal degeneration may aid clinical trial efforts

A series of studies demonstrate improved detection of the second most common form of dementia, providing diagnostic specificity that clears the way for refined clinical trials testing targeted treatments. The new research is being presented by experts from the Perelman School of Medicine at the University of Pennsylvania at the American Academy of Neurology's 65th Annual Meeting in San Diego March 16-23, 2013.

Frontotemporal degeneration, the most common in people under 60, can be hereditary or sporadic in nature and caused by one of two different mutated proteins (tau or TDP-43). The disease results in damage to the anterior temporal and/or frontal lobes of the brain. As the disease progresses, it becomes increasingly difficult for people to plan or organize activities, behave appropriately in social or work settings, interact with others, and care for oneself, resulting in increasing dependency.

In one study, the team confirmed that a novel multimodal imaging approach was more accurate (88 percent) than using either MRI (72 percent) or DTI (81 percent) alone to detect FTD versus Alzheimer's disease. The two imaging techniques integrate measures of and , providing a statistically powerful method for predicting underlying pathology in order to screen patients for clinical trials.

"We are moving forward on our biomarker work to optimize our ability to identify the specific cause of an individual's difficulties during life, said senior author Murray Grossman, MD, EdD, professor of Neurology and director of the Penn FTLD Center. "We use a novel multi-modality approach involving behavioral, imaging and biofluid biomarker measures."

In a second study, researchers found that a brief series of of memory, word generation and conceptual flexibility (needed for -solving) helped differentiate people with very mild behavioral variant FTD (bvFTD) and those with (MCI). The combination of tests correctly classified 85.7 percent of bvFTD cases and 83.3 percent of MCI cases at early stages of disease.

"This is particularly important because treatment trials with disease-modifying agents are emerging, often based on animal studies, yet we still don't have all the tools we need to identify who is most appropriate to participate in one of these trials. Moreover, we can use this information we ascertain to help determine who is responding to a treatment in a clinical trial."

The third study being presented at the meeting showed that hereditary forms of FTD appear to have more rapid cognitive decline and differing tau profiles compared with sporadic forms of the disease. For clinical trials testing whether a drug can delay damage caused by tau, any known differences in the speed of disease progression could interfere with trial results.

More information: [P06.034] The Power of Multimodal Neuroimaging Biomarkers for Clinical Trial Screening
Thursday, March 21, 2013 7:30 AM

[P03.086] Utility of Neuropsychological Testing in the Differential Diagnosis of Early Behavioral Variant Frontotemporal Dementia (bvFTD) and Mild Cognitive Impairment (MCI)
Tuesday, March 19, 2013 2:00 PM

[P05.102] Longitudinal Cognitive Performance and Cerebrospinal Fluid Biomarkers in Sporadic and Hereditary Frontotemporal Lobar Degeneration
Wednesday, March 20, 2013 2:00 PM

add to favorites email to friend print save as pdf

Related Stories

Brief exam diagnoses cognitive impairment in ALS patients

Jun 22, 2011

(Medical Xpress) -- Patients with amyotrophic lateral sclerosis (ALS) could lose brain function earlier than is noticeably detectable, affecting their ability to make decisions about their care. Physicians need a method to ...

New research supports upcoming Alzheimer's disease guidelines

Aug 01, 2011

Two new studies published in the August issue of The Journal of Nuclear Medicine (JNM) provide insight into the potential of positron emission tomography (PET) to differentiate between types of dementia and to identify pharma ...

Recommended for you

Researchers track down cause of eye mobility disorder

9 hours ago

Imagine you cannot move your eyes up, and you cannot lift your upper eyelid. You walk through life with your head tilted upward so that your eyes look straight when they are rolled down in the eye socket. ...

How kids' brain structures grow as memory develops

10 hours ago

Our ability to store memories improves during childhood, associated with structural changes in the hippocampus and its connections with prefrontal and parietal cortices. New research from UC Davis is exploring ...

User comments