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At present there are about 47.5 million people having different types of dementia and by 2030 this number would reach 75.6 million. This obviously brings about a serious social and economic burden for people who take care for those with any kind of dementia. The purpose of this article is to explore only semantic dementia (SD), more specifically called semantic variant of primary progressive aphasia, as one of the forms of frontotemporal dementia (FTD) and provide the latest information on its diagnosis and treatment which play a significant role in the maintenance of quality of life of both patients and their caregivers. Especially unimpaired communication is one of the key factors in the relationship between the patients and their caregivers. The methods used for this mini review include a literature review of available sources found in the world's acknowledged databases such as Web of Science, PubMed, Springer and Scopus from 2000 to 2015; and a comparison and evaluation of the selected studies. The findings of this mini review show that FTD, respectively SD, is a serious neurodegenerative disorder which has fatal consequences for the affected patients. In addition, the findings also indicate that there are not many possibilities of pharmacological treatment for semantic dementia and therefore more attention should be paid to alternative, non-pharmacological approaches. Although semantic dementia is a relatively rare neurodegenerative disorder if compared with other types of dementia, it has an irreversible impact on patient's and his/her caregiver's life in terms of quality.
- Klíčová slova
- Frontotemporal dementia, diagnosis, patient, quality of life, semantic dementia, treatment,
- MeSH
- frontotemporální demence * diagnóza farmakoterapie MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
BACKGROUND: Semantic and short-term episodic memory are impaired in some brain disorders including Alzheimer's disease. OBJECTIVE: Development and validation of an almost self-administered, but cognitively demanding four-minute test identifying very mild cognitive impairment (vMCI). METHODS: The innovative hedgehog PICture Naming and Immediate Recall (PICNIR) consisted of two parts. The first task was to write down the names of 20 black-and-white pictures to evaluate long-term semantic memory and language. The second task involves immediate recall and writing the names of as many previously named pictures as possible in one minute. The PICNIR is assessed using the number of naming errors (NE) and correctly recalled picture names (PICR). The PICNIR and a neuropsychological battery were administered to 190 elderly individuals living independently in the community. They were divided into those with vMCI (n = 43 with Montreal Cognitive Assessment (MoCA) 24 ± 3 points) and sociodemographically matched cognitively normal (CN) individuals (n = 147 with MoCA 26 ± 3). Both subgroups had predicted mean Mini-Mental State Examination scores of 28-29 points. RESULTS: Compared to CN, vMCI participants made more NE (0.3 ± 0.6 versus 0.6 ± 0.9; p = 0.02) and recalled fewer PICR (8.9 ± 2.2 versus 6.8 ± 2.2; p < 0.000001). Discriminative validity was satisfactory using the area under the ROC curve (AUC): 0.76 for PICR, 0.74 for MoCA, 0.67 for MoCA-five-word recall, and 0.59 for NE. The AUCs of PICR and MoCA were comparable and larger than those of MoCA five-point recall or NE. Logical Memory scores, RAVLT scores, Digit symbol, and animal fluency correlated with PICR. CONCLUSIONS: The picture-based PICNIR is an ultra-brief, sensitive cognitive test valid for assessing very mild cognitive impairment. Its effectiveness should be validated for other languages and cultures.
- Klíčová slova
- Alzheimer's disease, PICNIR, dementia, episodic memory, hedgehog PICture naming and immediate recall, mild cognitive impairment, picture, screening, semantic memory, test,
- MeSH
- epizodická paměť * MeSH
- kognitivní dysfunkce * diagnóza psychologie MeSH
- krátkodobá paměť fyziologie MeSH
- lidé MeSH
- neuropsychologické testy * statistika a číselné údaje MeSH
- reprodukovatelnost výsledků MeSH
- rozpomínání * fyziologie MeSH
- sémantika MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- testy pro posouzení mentálních funkcí a demence statistika a číselné údaje MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Behavioral variant frontotemporal dementia (bvFTD) is characterized by profound and early deficits in social cognition (SC) and executive functions (EF). To date it remains unclear whether deficits of the respective cognitive domains are based on the degeneration of distinct brain regions. In 103 patients with a diagnosis of bvFTD (possible/probable/definite: N = 40/58/5) from the frontotemporal lobar degeneration (FTLD) consortium Germany cohort (age 62.5±9.4 years, gender 38 female/65 male) we applied multimodal structural imaging, i.e. voxel-based morphometry, cortical thickness (CTH) and networks of structural covariance via source based morphometry. We cross-sectionally investigated associations with performance in a modified Reading the Mind in the Eyes Test (RMET; reflective of theory of mind - ToM) and five different tests reflective of EF (i.e. Hamasch-Five-Point Test, semantic and phonemic Fluency, Trail Making Test, Stroop interference). Finally, we investigated the conjunction of RMET correlates with functional networks commonly associated with SC respectively ToM and EF as extracted meta-analytically within the Neurosynth database. RMET performance was mainly associated with gray matter volume (GMV) and CTH within temporal and insular cortical regions and less within the prefrontal cortex (PFC), whereas EF performance was mainly associated with prefrontal regions (GMV and CTH). Overlap of RMET and EF associations was primarily located within the insula, adjacent subcortical structures (i.e. putamen) and the dorsolateral PFC (dlPFC). These patterns were more pronounced after adjustment for the respective other cognitive domain. Corroborative results were obtained in analyses of structural covariance networks. Overlap of RMET with meta-analytically extracted functional networks commonly associated with SC, ToM and EF was again primarily located within the temporal and insular region and the dlPFC. In addition, on a meta-analytical level, strong associations were found for temporal cortical RMET correlates with SC and ToM in particular. These data indicate a temporo-frontal dissociation of bvFTD related disturbances of ToM and EF, with atrophy of the anterior temporal lobe being critically involved in ToM deficits. The consistent overlap within the insular cortex may be attributable to the multimodal and integrative role of this region in socioemotional and cognitive processing.
- Klíčová slova
- Executive functions, Frontotemporal dementia, Magnetic resonance imaging, Reading the Mind in the Eyes Test, Social cognition, Theory of mind,
- MeSH
- exekutivní funkce * fyziologie MeSH
- frontotemporální demence * patologie diagnostické zobrazování patofyziologie psychologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie * MeSH
- mozek diagnostické zobrazování patologie MeSH
- neuropsychologické testy * MeSH
- průřezové studie MeSH
- senioři MeSH
- sociální kognice MeSH
- teorie mysli * fyziologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND AND PURPOSE: Frontotemporal dementia (FTD) is a neurodegenerative disorder characterized by pervasive personality and behavioural disturbances with severe impact on patients and caregivers. In current clinical practice, treatment is based on nonpharmacological and pharmacological approaches. Unfortunately, trial-based evidence supporting symptomatic pharmacological treatment for the behavioural disturbances in FTD is scarce despite the significant burden this poses on the patients and caregivers. METHOD: The study examined drug management decisions for several behavioural disturbances in patients with FTD by 21 experts across European expert centres affiliated with the European Reference Network for Rare Neurological Diseases (ERN-RND). RESULTS: The study revealed the highest consensus on drug treatments for physical and verbal aggression, impulsivity and obsessive delusions. Antipsychotics (primarily quetiapine) were recommended for behaviours posing safety risks to both patients and caregivers (aggression, self-injury and self-harm) and nightly unrest. Selective serotonin reuptake inhibitors were recommended for perseverative somatic complaints, rigidity of thought, hyperphagia, loss of empathy and for impulsivity. Trazodone was specifically recommended for motor unrest, mirtazapine for nightly unrest, and bupropion and methylphenidate for apathy. Additionally, bupropion was strongly advised against in 10 out of the 14 behavioural symptoms, emphasizing a clear recommendation against its use in the majority of cases. CONCLUSIONS: The survey data can provide expert guidance that is helpful for healthcare professionals involved in the treatment of behavioural symptoms. Additionally, they offer insights that may inform prioritization and design of therapeutic studies, particularly for existing drugs targeting behavioural disturbances in FTD.
- Klíčová slova
- drug therapy, expert testimony, frontotemporal dementia, neurobehavioural manifestations, neurodegenerative diseases,
- MeSH
- agrese účinky léků MeSH
- antipsychotika terapeutické užití MeSH
- frontotemporální demence * farmakoterapie MeSH
- impulzivní chování účinky léků MeSH
- konsensus MeSH
- lidé MeSH
- selektivní inhibitory zpětného vychytávání serotoninu terapeutické užití MeSH
- vzácné nemoci farmakoterapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH
- Názvy látek
- antipsychotika MeSH
- selektivní inhibitory zpětného vychytávání serotoninu MeSH
We investigated the mutation spectrum of the TANK-Binding Kinase 1 (TBK1) gene and its associated phenotypic spectrum by exonic resequencing of TBK1 in a cohort of 2,538 patients with frontotemporal dementia (FTD), amyotrophic lateral sclerosis (ALS), or FTD plus ALS, ascertained within the European Early-Onset Dementia Consortium. We assessed pathogenicity of predicted protein-truncating mutations by measuring loss of RNA expression. Functional effect of in-frame amino acid deletions and missense mutations was further explored in vivo on protein level and in vitro by an NFκB-induced luciferase reporter assay and measuring phosphorylated TBK1. The protein-truncating mutations led to the loss of transcript through nonsense-mediated mRNA decay. For the in-frame amino acid deletions, we demonstrated loss of TBK1 or phosphorylated TBK1 protein. An important fraction of the missense mutations compromised NFκB activation indicating that at least some functions of TBK1 are lost. Although missense mutations were also present in controls, over three times more mutations affecting TBK1 functioning were found in the mutation fraction observed in patients only, suggesting high-risk alleles (P = 0.03). Total mutation frequency for confirmed TBK1 LoF mutations in the European cohort was 0.7%, with frequencies in the clinical subgroups of 0.4% in FTD, 1.3% in ALS, and 3.6% in FTD-ALS.
- Klíčová slova
- ALS, FTD, NFκB luciferase reporter assay, TANK-Binding Kinase 1, TBK1, amyotrophic lateral sclerosis, frontotemporal dementia, mutations,
- MeSH
- aktivace enzymů MeSH
- alely MeSH
- amyotrofická laterální skleróza diagnóza epidemiologie genetika MeSH
- běloši genetika MeSH
- fenotyp MeSH
- frontotemporální demence diagnóza epidemiologie genetika MeSH
- genetické asociační studie MeSH
- heterozygot MeSH
- kohortové studie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mutace MeSH
- NF-kappa B metabolismus MeSH
- protein-serin-threoninkinasy genetika metabolismus MeSH
- sekvenční delece MeSH
- senioři MeSH
- studie případů a kontrol MeSH
- substituce aminokyselin MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- NF-kappa B MeSH
- protein-serin-threoninkinasy MeSH
- TBK1 protein, human MeSH Prohlížeč
There is a strong genetic influence on the clinicopathological phenotypes associated with frontotemporal lobar degeneration (FTLD) and frontotemporal dementia (FTD). Intracellular deposition of TDP-43 is the phenotypical hallmark of a frequent subgroup of cases. Mutations in the sequestosome 1 (SQSTM1) gene have rarely been found in individuals with FTD. Here we provide a comprehensive clinicopathological description of two cases with a SQSTM1 mutation. The clinical phenotype of patient 1 (mutation p.Glu396*) was compatible with the behavioural variant (bv) of FTD. TDP-43 pathology was consistent with the features of type B of FTLD-TDP pathology. However, prominent neuronal granular cytoplasmic TDP-43 immunoreactivity and abundant oligodendroglial inclusions, proven by colocalization with the oligodendroglial-marker TPPP/p25, were also seen. The clinical phenotype of patient 2 was compatible with bvFTD associated with parkinsonism and bulbar symptoms in the later stage. Genetic testing of patient 2 identified a C9orf72 repeat expansion mutation together with a missense mutation (p.Arg212Cys) in SQSTM1. TDP-43 pathology was characterized by neuritic profiles compatible mostly with type A. In contrast to patient 1, p62 pathology was seen to a greater extent as TDP-43 immunoreactivity in neurons. Using an antibody that detects poly(GP) peptides produced via repeat associated non-ATG translation associated with expanded hexanucleotide repeat in the C9orf72 gene, we confirmed the presence of pathognomonic inclusions. The present study supports previous observations on amyotrophic lateral sclerosis (ALS) that SQSTM1 mutations consistently associate with TDP-43 pathology. The co-presence of C9orf72 mutation may influence the phenotype, thus finding one FTLD (or ALS) related mutation does not exclude the presence of further influential genetic alterations. Oligodendroglial TDP-43 pathology is considerable in some forms of FTLD-TDP, thus their evaluation might be considered to be included in classification systems.
- Klíčová slova
- FTD, SQSTM1, TDP-43, amyotrophic lateral sclerosis, p62,
- MeSH
- adaptorové proteiny signální transdukční genetika MeSH
- chování MeSH
- dospělí MeSH
- expanze repetic DNA MeSH
- frontotemporální demence genetika MeSH
- lidé středního věku MeSH
- lidé MeSH
- missense mutace genetika MeSH
- mutační analýza DNA MeSH
- neurity patologie MeSH
- neurony patologie MeSH
- oligodendroglie patologie MeSH
- progrese nemoci MeSH
- protein C9orf72 MeSH
- proteinopatie TDP-43 genetika patologie MeSH
- proteiny genetika MeSH
- protoonkogenní proteiny c-myc genetika MeSH
- sekvestosom 1 MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- práce podpořená grantem MeSH
- Názvy látek
- adaptorové proteiny signální transdukční MeSH
- C9orf72 protein, human MeSH Prohlížeč
- protein C9orf72 MeSH
- proteiny MeSH
- protoonkogenní proteiny c-myc MeSH
- sekvestosom 1 MeSH
- SQSTM1 protein, human MeSH Prohlížeč
Innovative memory paradigms have been introduced to capture subtle memory changes in early Alzheimer's disease (AD). We aimed to examine the associations between different indexes of the challenging Memory Binding Test (MBT) and hippocampal volume (HV) in a sample of individuals with subjective cognitive decline (SCD; n = 50), amnestic mild cognitive impairment (aMCI) due to AD (n = 31), and cognitively normal (CN) older adults (n = 29) recruited from the Czech Brain Aging Study, in contrast to traditional verbal memory tests. Both MBT free and cued recall scores in immediate and delayed recall conditions were associated with lower HV in both SCD and aMCI due to AD, whereas in traditional verbal memory tests only delayed recall scores were associated with lower HV. In SCD, the associations with lower HV in the immediate recall covered specific cued recall indexes only. In conclusion, the MBT is a promising test for detecting subtle hippocampal-associated memory decline during the predementia continuum.
- Klíčová slova
- Alzheimer’s disease, challenging tests, free and cued verbal memory, medial temporal lobe atrophy, mild cognitive impairment, semantic memory binding, subjective cognitive decline,
- MeSH
- demence * diagnóza MeSH
- hipokampus MeSH
- kognice MeSH
- krátkodobá paměť MeSH
- lidé MeSH
- rozpomínání * MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Patients with subjective cognitive decline (SCD) are at higher risk for conversion to dementia due to Alzheimer's disease (AD). Semantic verbal fluency (SVF) seems to be impaired in the early stages of AD. The goal of the present study was to identify the discriminative potential of verbal fluency (VF) in patients with SCD to show if very early signs of cognitive decline may be detected in SCD. We examined 93 normal controls (NC) and 61 participants with SCD. Each participant was administered a comprehensive neuropsychological battery. All participants underwent tests of VF: phonemic verbal fluency (PVF), letters K and P and SVF (animals and vegetables categories). In addition to the total score, two 30-second intervals, and clustering and switching indices in SVF were evaluated. SCD generated fewer words in the total score and 30- to 60-second interval in vegetables category and they performed more switches in animals category. There was no significant difference between the SCD and the NC groups in all other VF measures. Quantitative measures of SVF (a decreased number of vegetables) as well as qualitative measures were detected in SCD group and could be considered as an early neuropsychological marker of subtle cognitive impairment.
- Klíčová slova
- Alzheimer’s disease, elderly/aging, mild cognitive impairment, subjective cognitive decline, verbal fluency,
- MeSH
- analýza rozptylu MeSH
- kognitivní poruchy komplikace MeSH
- lidé středního věku MeSH
- lidé MeSH
- neuropsychologické testy MeSH
- poruchy řeči diagnóza etiologie MeSH
- retrospektivní studie MeSH
- sémantika * MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- verbální chování fyziologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Odor identification impairment is a feature of several neurodegenerative disorders. Although neurodegenerative changes in the frontotemporal lobar degeneration (FTLD) subtypes involve areas important for olfactory processing, data on olfactory function in these patients are limited. An 18-item, multiple-choice odor identification test developed at our memory clinic, the Motol Hospital smell test, was administered to 9 patients with behavioral variant frontotemporal dementia, 13 patients with the language variants, primary nonfluent aphasia (n = 7) and semantic dementia (n = 6), and 8 patients with progressive supranuclear palsy. Compared to the control group (n = 15), all FTLD subgroups showed significant impairment of odor identification (P < .05). The differences between the FTLD subgroups were not significant. No correlation between odor identification and neuropsychological tests results was found. Our data suggest that odor identification impairment is a symptom common to FTLD syndromes, and it seems to be based on olfactory structure damage rather than cognitive decline.
- Klíčová slova
- behavioral variant frontotemporal dementia, cognitive status, odor identification, primary nonfluent aphasia, progressive supranuclear palsy, semantic dementia,
- MeSH
- frontotemporální demence komplikace patofyziologie MeSH
- frontotemporální lobární degenerace komplikace patofyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- neuropsychologické testy MeSH
- odoranty * MeSH
- poruchy čichu komplikace patofyziologie MeSH
- primární progresivní nonfluentní afázie komplikace patofyziologie MeSH
- progresivní supranukleární obrna komplikace patofyziologie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- studie případů a kontrol MeSH
- stupeň závažnosti nemoci MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUND: Pathogenic heterozygous mutations in the progranulin gene (GRN) are a key cause of frontotemporal dementia (FTD), leading to significantly reduced biofluid concentrations of the progranulin protein (PGRN). This has led to a number of ongoing therapeutic trials aiming to treat this form of FTD by increasing PGRN levels in mutation carriers. However, we currently lack a complete understanding of factors that affect PGRN levels and potential variation in measurement methods. Here, we aimed to address this gap in knowledge by systematically reviewing published literature on biofluid PGRN concentrations. METHODS: Published data including biofluid PGRN concentration, age, sex, diagnosis and GRN mutation were collected for 7071 individuals from 75 publications. The majority of analyses (72%) had focused on plasma PGRN concentrations, with many of these (56%) measured with a single assay type (Adipogen) and so the influence of mutation type, age at onset, sex, and diagnosis were investigated in this subset of the data. RESULTS: We established a plasma PGRN concentration cut-off between pathogenic mutation carriers and non-carriers of 74.8 ng/mL using the Adipogen assay based on 3301 individuals, with a CSF concentration cut-off of 3.43 ng/mL. Plasma PGRN concentration varied by GRN mutation type as well as by clinical diagnosis in those without a GRN mutation. Plasma PGRN concentration was significantly higher in women than men in GRN mutation carriers (p = 0.007) with a trend in non-carriers (p = 0.062), and there was a significant but weak positive correlation with age in both GRN mutation carriers and non-carriers. No significant association was seen with weight or with TMEM106B rs1990622 genotype. However, higher plasma PGRN levels were seen in those with the GRN rs5848 CC genotype in both GRN mutation carriers and non-carriers. CONCLUSIONS: These results further support the usefulness of PGRN concentration for the identification of the large majority of pathogenic mutations in the GRN gene. Furthermore, these results highlight the importance of considering additional factors, such as mutation type, sex and age when interpreting PGRN concentrations. This will be particularly important as we enter the era of trials for progranulin-associated FTD.
- Klíčová slova
- Frontotemporal dementia, Progranulin,
- MeSH
- frontotemporální demence * genetika patologie MeSH
- lidé MeSH
- membránové proteiny genetika MeSH
- mezibuněčné signální peptidy a proteiny genetika MeSH
- mutace genetika MeSH
- progranuliny genetika MeSH
- proteiny nervové tkáně genetika MeSH
- virulence MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
- systematický přehled MeSH
- Názvy látek
- GRN protein, human MeSH Prohlížeč
- membránové proteiny MeSH
- mezibuněčné signální peptidy a proteiny MeSH
- progranuliny MeSH
- proteiny nervové tkáně MeSH
- TMEM106B protein, human MeSH Prohlížeč