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.

Frontotemporal dementia (FTD) affects behavior, emotion, language and decision-making. It slowly destroys a person’s ability to react appropriately in a social setting, and affects the ability to learn, memorize, reason, make decisions, empathize, communicate and eventually even carry out the most routine of daily activities.

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.

Several mutated genes have been found to be associated with different forms of this disease, each of them can lead to destruction of nerve cells in the temporal and frontal lobes of the brain. Currently there 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 of the disease.

Howard Rosen, MD, an associate professor of neurology at UCSF leads the study that is currently underway. The researchers are trying to find a way to use new imaging techniques to highlight the changes that occur in the brain as the disease progresses. This will enable them to identify biomarkers for diagnosis, and watch the impact experimental drugs will have on the brain areas affected.

According to Rose, “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.” 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.”

The UCSF researchers are working together with scientists from the Mayo Clinic in Rochester, Minnesota. They are studying 120 FTD patients and 80 cognitively normal control subjects and following each of the participants over the course of 18 months through a series of brain imaging, neurological examinations, and behavioral and cognitive assessments. Leading the Mayo Clinic team is neurologist David Knopman, MD.

Patients are found to have FTD 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.

Scientists will be obtaining several different types of images in each patient, some through structural magnetic resonance imaging (measures the size and shape of the brain), and positron emission tomography (examines metabolism, such as glucose consumption). Other images will be obtained through new MRI techniques that measure the blood content in the brain, and using a technique called diffusion tensor imaging that determines the integrity of the neural wiring, or axons, connecting 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 later 2012.



About the author:

Ron White is a two-time USA Memory Champion and memory expert. As a memory speaker he travels the world to speak before large groups or small company seminars, demonstrating his memory skills and teaching others how to improve their memory, and how important a good memory is in all phases of your life. 



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