[Pathomechanisms and clinical aspects of frontotemporal lobar degeneration]. / Pathomechanismen und klinische Aspekte der frontotemporalen Lobärdegeneration.
Nervenarzt
; 88(2): 163-172, 2017 Feb.
Article
em De
| MEDLINE
| ID: mdl-27999880
ABSTRACT
BACKGROUND:
Frontotemporal lobar degeneration (FTLD) includes a spectrum of heterogeneous clinical and neuropathological diseases. In a strict sense this includes the behavioral variant of frontotemporal dementia (bvFTD) and primary progressive aphasia (PPA) and both variants can be associated with amyotrophic lateral sclerosis (FTD-ALS). In a broader sense FTLD also includes progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS). In recent years the strong genetic component of FTLD has become increasingly clear.OBJECTIVE:
The association between clinical presentation, neuropathology, genetics and pathophysiological mechanisms of FTLD are presented.RESULTS:
The diagnostic criteria and tools for the clinical differential diagnosis of FTLD are presented. At autopsy patients show neuronal and glial inclusions of Tau, TDP-43 or FUS. While Tau pathology is often associated with extrapyramidal symptoms, patients with TDP-43 and FUS inclusions often also show signs of ALS. Pathogenic mutations directly increase the aggregation propensity of these proteins or impair protein degradation through autophagy or the proteasome. Pathogenic mutations in most FTLD genes trigger cytoplasmic missorting and aggregation of the RNA-binding protein TDP-43 and thus lead to a nuclear loss of TDP-43 function. Microgliosis and mutations in GRN and TREM2 suggest an important role of neuroinflammation in FTLD.CONCLUSION:
There is still no causal therapy for FTLD but preclinical studies focusing on pathogenic mutations in C9orf72, GRN and Tau may lead to clinical trials soon; therefore, establishing large well characterized patient cohorts is crucial for trial readiness.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Predisposição Genética para Doença
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Polimorfismo de Nucleotídeo Único
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Degeneração Lobar Frontotemporal
/
Proteínas do Tecido Nervoso
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
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Prevalence_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
/
Male
País/Região como assunto:
Europa
Idioma:
De
Revista:
Nervenarzt
Ano de publicação:
2017
Tipo de documento:
Article