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Pivot Concepts:
Gene/Protein
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Target Concepts:
Gene/Protein
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Query: UNIPROT:P10636 (
tau protein
)
5,110
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
In order to treat frontotemporal dementia (FTD) we must first evaluate the patient's medical condition, as well as his or her social setting (caregiver, financial resources, home characteristics). Primary health-care team must receive information about the patient's disease, and the family should be informed about the disease itself and the social resources they can ask for. It is advisable to formulate a therapeutic scheme including some counsels to improve the suitability of environment, social help measures, behaviour therapy, cognitive stimulation and pharmacological treatment. Atypical antipsychotics have improved "positive symptoms" as logorrhoea, wandering,
agitation
and aggression, without impairing cognitive function. Selective serotonin reuptake inhibitors improve depressive symptoms, compulsions, food craving and disinhibition. A few reports suggest that idazoxan (alpha 2-noradrenergic antagonist) can improve attention, verbal fluency and planning efficiency. In some cases with "FTD and parkinsonism linked to chromosome 17" it could be justified to perform a genetic analysis to the offspring, in order to know if genetic counseling is necessary. An inflammatory reaction has been observed in brain damaged areas, and therefore antiinflammatory treatment efficacy should be investigated. It would also be interesting to look for neuroprotective agents that lessen the
tau protein
abnormality. All types of receptors which are involved in FTD should be identified, and then their selective agonists or antagonists could be administered in synergic combinations. We hope that all genetic alterations producing or facilitating FTD are eventually known, and harmless curative means are developed.
...
PMID:[Frontotemporal dementia: therapeutic possibilities]. 1072 74
An expanded hexanucleotide repeat in the C9ORF72 gene has recently been identified as a major cause of familial frontotemporal lobar degeneration and motor neuron disease, including cases previously identified as linked to chromosome 9. Here we present a detailed retrospective clinical, neuroimaging and histopathological analysis of a C9ORF72 mutation case series in relation to other forms of genetically determined frontotemporal lobar degeneration ascertained at a specialist centre. Eighteen probands (19 cases in total) were identified, representing 35% of frontotemporal lobar degeneration cases with identified mutations, 36% of cases with clinical evidence of motor neuron disease and 7% of the entire cohort. Thirty-three per cent of these C9ORF72 cases had no identified relevant family history. Families showed wide variation in clinical onset (43-68 years) and duration (1.7-22 years). The most common presenting syndrome (comprising a half of cases) was behavioural variant frontotemporal dementia, however, there was substantial clinical heterogeneity across the C9ORF72 mutation cohort. Sixty per cent of cases developed clinical features consistent with motor neuron disease during the period of follow-up. Anxiety and
agitation
and memory impairment were prominent features (between a half to two-thirds of cases), and dominant parietal dysfunction was also frequent. Affected individuals showed variable magnetic resonance imaging findings; however, relative to healthy controls, the group as a whole showed extensive thinning of frontal, temporal and parietal cortices, subcortical grey matter atrophy including thalamus and cerebellum and involvement of long intrahemispheric, commissural and corticospinal tracts. The neuroimaging profile of the C9ORF72 expansion was significantly more symmetrical than progranulin mutations with significantly less temporal lobe involvement than
microtubule-associated protein tau
mutations. Neuropathological examination in six cases with C9ORF72 mutation from the frontotemporal lobar degeneration series identified histomorphological features consistent with either type A or B TAR DNA-binding protein-43 deposition; however, p62-positive (in excess of TAR DNA-binding protein-43 positive) neuronal cytoplasmic inclusions in hippocampus and cerebellum were a consistent feature of these cases, in contrast to the similar frequency of p62 and TAR DNA-binding protein-43 deposition in 53 control cases with frontotemporal lobar degeneration-TAR DNA-binding protein. These findings corroborate the clinical importance of the C9ORF72 mutation in frontotemporal lobar degeneration, delineate phenotypic and neuropathological features that could help to guide genetic testing, and suggest hypotheses for elucidating the neurobiology of a culprit subcortical network.
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PMID:Frontotemporal dementia with the C9ORF72 hexanucleotide repeat expansion: clinical, neuroanatomical and neuropathological features. 2236 91