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Review
. 2013 Oct;169(10):820-4.
doi: 10.1016/j.neurol.2013.07.010. Epub 2013 Sep 4.

Presymptomatic studies in genetic frontotemporal dementia

Affiliations
Review

Presymptomatic studies in genetic frontotemporal dementia

J D Rohrer et al. Rev Neurol (Paris). 2013 Oct.

Abstract

Approximately 20% of patients with the neurodegenerative disorder frontotemporal dementia (FTD) have an autosomal dominant pattern of inheritance. Genetic FTD is caused by mutations in three genes in most cases (progranulin, microtubule-associated protein tau and chromosome 9 open reading frame 72) although a number of other genes are rare causes. Studies of other neurodegenerative diseases have shown imaging and biomarker evidence of disease onset many years prior to the development of symptoms. Similar studies in genetic FTD are now revealing evidence of a series of presymptomatic changes, initially in plasma biomarkers followed by MR imaging abnormalities of functional and structural connectivity and then grey matter atrophy. Lastly, neuropsychometric tests become abnormal in proximity to the onset of symptoms. Such studies have been relatively small until now but research centres with an expertise in genetic FTD are now forming consortia such as the Genetic Frontotemporal Dementia Initiative (GenFI) to create larger cohorts that can form the basis of future clinical trials.

Les démences frontotemporales (DFT), dans environ 20 % des cas, résultent d’un mode de transmission autosomique dominant. Les trois causes génétiques les plus fréquentes sont des mutations des gènes GRN, MAPT et des expansions hexanucléotidiques au sein du gène C9orf72, alors que d’autres gènes sont plus rarement impliqués. Des études dans d’autres maladies neurodégénératives ont montré que des marqueurs biologiques et d’imagerie du début de la maladie précèdent de plusieurs années les premiers symptômes. Des études similaires concernant les formes génétiques des DFT mettent actuellement en évidence des modifications présymptomatiques, initialement des biomarqueurs plasmatiques, suivies des modifications en imagerie de la connectivité fonctionnelle et structurelle puis des signes d’atrophie de la substance grise. Enfin, les performances aux tests neuropsychologiques deviennent anormales dans la période proche du début des symptômes. Ces études restent peu nombreuses mais les centres ayant une expertise dans la génétique des DFT se regroupent actuellement en consortium tel que l’Initiative pour la Génétique des Démences FrontoTemporales (GenFI) afin de disposer de larges cohortes qui serviront de base au développement des futurs essais cliniques.

Keywords: Aphasie progressive primaire; C9ORF72; C9orf72; Dégénérescence lobaire frontotemporale; Démence frontotemporale; Frontotemporal dementia; MAPT; Primary progressive aphasia; Progranulin; Progranuline; Tau.

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