Individualized atrophy scores predict dementia onset in familial frontotemporal lobar degeneration

Alzheimers Dement. 2020 Jan;16(1):37-48. doi: 10.1016/j.jalz.2019.04.007. Epub 2020 Jan 6.

Abstract

Introduction: Some models of therapy for neurodegenerative diseases envision starting treatment before symptoms develop. Demonstrating that such treatments are effective requires accurate knowledge of when symptoms would have started without treatment. Familial frontotemporal lobar degeneration offers a unique opportunity to develop predictors of symptom onset.

Methods: We created dementia risk scores in 268 familial frontotemporal lobar degeneration family members by entering covariate-adjusted standardized estimates of brain atrophy into a logistic regression to classify asymptomatic versus demented participants. The score's predictive value was tested in a separate group who were followed up longitudinally (stable vs. converted to dementia) using Cox proportional regressions with dementia risk score as the predictor.

Results: Cross-validated logistic regression achieved good separation of asymptomatic versus demented (accuracy = 90%, SE = 0.06). Atrophy scores predicted conversion from asymptomatic or mildly/questionably symptomatic to dementia (HR = 1.51, 95% CI: [1.16,1.98]).

Discussion: Individualized quantification of baseline brain atrophy is a promising predictor of progression in asymptomatic familial frontotemporal lobar degeneration mutation carriers.

Keywords: Frontotemporal dementia; Genetics; Magnetic resonance imaging (MRI); TDP-43; Tau.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Atrophy / pathology*
  • Brain / pathology
  • C9orf72 Protein / genetics
  • Female
  • Frontotemporal Dementia* / diagnostic imaging
  • Frontotemporal Dementia* / genetics
  • Genetic Predisposition to Disease*
  • Humans
  • Image Processing, Computer-Assisted / statistics & numerical data
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Mutation / genetics*
  • Neuropsychological Tests / statistics & numerical data*
  • Progranulins / genetics
  • tau Proteins / genetics

Substances

  • C9orf72 Protein
  • C9orf72 protein, human
  • GRN protein, human
  • MAPT protein, human
  • Progranulins
  • tau Proteins