Improved detection of frontotemporal degeneration may aid clinical trial efforts

March 15, 2013

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.

Explore further: Range of diagnostic spinal fluid tests needed to differentiate concurrent brain diseases

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

Related Stories

Range of diagnostic spinal fluid tests needed to differentiate concurrent brain diseases

April 20, 2012
Teasing out the exact type or types of dementia someone suffers from is no easy task; neurodegenerative brain diseases share common pathology and often co-occur. Researchers from the Perelman School of Medicine at the University ...

MRI can screen patients for Alzheimer's disease or frontotemporal lobar degeneration

December 26, 2012
When trying to determine the root cause of a person's dementia, using an MRI can effectively and non-invasively screen patients for Alzheimer's disease or Frontotemporal Lobar Degeneration (FTLD), according to a new study ...

Improving diagnostic exams for dementia: Promising treatment implications

October 22, 2012
(Medical Xpress)—The number of people affected by dementias continues to climb as baby boomers age, increasing the urgency to identify ways to prevent, diagnose and treat these neurodegenerative brain disorders.

Brief exam diagnoses cognitive impairment in ALS patients

June 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

August 1, 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 pharmaceuticals ...

Widespread brain atrophy detected in Parkinson's disease with newly developed structural pattern

December 12, 2011
Atrophy in the hippocampus, the region of the brain known for memory formation and storage, is evident in Parkinson's disease (PD) patients with cognitive impairment, including early decline known as mild cognitive impairment ...

Recommended for you

Faulty support cells disrupt communication in brains of people with schizophrenia

July 20, 2017
New research has identified the culprit behind the wiring problems in the brains of people with schizophrenia. When researchers transplanted human brain cells generated from individuals diagnosed with childhood-onset schizophrenia ...

Scientists discover combined sensory map for heat, humidity in fly brain

July 20, 2017
Northwestern University neuroscientists now can visualize how fruit flies sense and process humidity and temperature together through a "sensory map" within their brains, according to new research.

Scientists reveal how patterns of brain activity direct specific body movements

July 20, 2017
New research by Columbia scientists offers fresh insight into how the brain tells the body to move, from simple behaviors like walking, to trained movements that may take years to master. The discovery in mice advances knowledge ...

Team traces masculinization in mice to estrogen receptor in inhibitory neurons

July 20, 2017
Researchers at Cold Spring Harbor Laboratory (CSHL) have opened a black box in the brain whose contents explain one of the remarkable yet mysterious facts of life.

Speech language therapy delivered through the Internet leads to similar improvements as in-person treatment

July 20, 2017
Telerehabilitation helps healthcare professionals reach more patients in need, but some worry it doesn't offer the same quality of care as in-person treatment. This isn't the case, according to recent research by Baycrest.

New study reveals contrasts in how groups of neurons function during decision making

July 19, 2017
By training mice to perform a sound identification task in a virtual reality maze, researchers at Harvard Medical School and the Istituto Italiano di Tecnologia (IIT) have identified striking contrasts in how groups of neurons ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.