Study on the clinical features of the prodromal stage of frontotemporal lobar degeneration

2021 Fiscal Year Final Research Report

• Project/Area Number: 19K08045
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 52030:Psychiatry-related
• Research Institution: Osaka University
• Principal Investigator: IKEDA MANABU 大阪大学, 医学系研究科, 教授 (60284395)
• Co-Investigator(Kenkyū-buntansha): 引田 咲良 大阪大学, 医学系研究科, 技術補佐員 (00834805) ; 鈴木 麻希 大阪大学, 連合小児発達学研究科, 寄附講座講師 (80422145) ; 釜江 和恵 大阪大学, 連合小児発達学研究科, 特任講師 (90553256)
• Project Period (FY): 2019-04-01 – 2022-03-31
• Keywords: 前頭側頭葉変性症 / 前頭側頭型認知症 / 行動異常型前頭側頭型認知症 / 意味性認知症 / バイオマーカー / Prodromal期

Outline of Final Research Achievements

The diagnosis of Frontotemporal dementia (FTD) in the prodromal stage remains challenging because of the limited evidence of clinical symptoms, and the limited accuracy of neuroimaging
We retrospectively investigated the clinical records and examined the neuropathology of FTD patients to identify symptoms appearing within 2 years of the first clinically apparent changes. It is seen in over 50% of early bvFTD patients, and distinct language features appear in the early stage of semantic dementia (SD). Both of them frequently present with additional symptoms, not included in the usual diagnostic criteria, such as physical signs, reticence, delusions.
We clarified the neuropsychiatric symptoms of right-sided predominant semantic dementia (SD-R) by comparing them with those of bvFTD, left-sided predominant SD (SD-L), Alzheimer’s disease (AD). SD-R seemed to be a similar condition to bvFTD rather than SD-L regarding behavioral symptoms, even in its early stage (Sato S et al, 2021).

Free Research Field

老年精神医学，神経心理学

Academic Significance and Societal Importance of the Research Achievements

前頭側頭型認知症において、発症ごく初期の症状を明らかにできたことにより、Prodromal期から出現していると考えられる症状が予測できるようになった。今後、アルツハイマー病のように疾患修飾薬の開発が順調に進めば、臨床試験の対象を今回明らかになった症状を指標にprodromal期から抽出できる可能性が出てきたと思われる。