Woollacott Ione O C, Rohrer Jonathan D
Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK.
J Neurochem. 2016 Aug;138 Suppl 1:6-31. doi: 10.1111/jnc.13654. Epub 2016 Jun 15.
The term frontotemporal dementia (FTD) describes a clinically, genetically and pathologically diverse group of neurodegenerative disorders. Symptoms of FTD can present in individuals in their 20s through to their 90s, but the mean age at onset is in the sixth decade. The most common presentation is with a change in personality and impaired social conduct (behavioural variant FTD). Less frequently patients present with language problems (primary progressive aphasia). Both of these groups of patients can develop motor features consistent with either motor neuron disease (usually the amyotrophic lateral sclerosis variant) or parkinsonism (most commonly a progressive supranuclear palsy or corticobasal syndrome). In about a third of cases FTD is familial, with mutations in the progranulin, microtubule-associated protein tau and chromosome 9 open reading frame 72 genes being the major causes. Mutations in a number of other genes including TANK-binding kinase 1 are rare causes of familial FTD. This review aims to clarify the often confusing terminology of FTD, and outline the various clinical features and diagnostic criteria of sporadic and familial FTD syndromes. It will also discuss the current major challenges in FTD research and clinical practice, and potential areas for future research. This review clarifies the terminology of frontotemporal dementia (FTD) and summarizes the various clinical features and most recent diagnostic criteria of sporadic and familial FTD syndromes. It also discusses the current major challenges in FTD research and clinical practice, and highlights potential areas for future research.
额颞叶痴呆(FTD)这一术语描述了一组临床、遗传和病理方面具有多样性的神经退行性疾病。FTD的症状可出现在20多岁至90多岁的个体中,但平均发病年龄在60岁左右。最常见的表现是人格改变和社交行为受损(行为变异型FTD)。较少见的情况是患者出现语言问题(原发性进行性失语)。这两组患者都可能出现与运动神经元病(通常是肌萎缩侧索硬化变异型)或帕金森综合征(最常见的是进行性核上性麻痹或皮质基底节综合征)一致的运动特征。在大约三分之一的病例中,FTD是家族性的,原颗粒蛋白、微管相关蛋白tau和9号染色体开放阅读框72基因的突变是主要病因。包括TANK结合激酶1在内的许多其他基因的突变是家族性FTD的罕见病因。本综述旨在澄清FTD常常令人困惑的术语,并概述散发性和家族性FTD综合征的各种临床特征和诊断标准。它还将讨论FTD研究和临床实践中当前的主要挑战,以及未来研究的潜在领域。本综述澄清了额颞叶痴呆(FTD)的术语,总结了散发性和家族性FTD综合征的各种临床特征和最新诊断标准。它还讨论了FTD研究和临床实践中当前的主要挑战,并突出了未来研究的潜在领域。