Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.
Department of Clinical Genetics, Amsterdam Neuroscience, Amsterdam UMC, Amsterdam, The Netherlands.
J Alzheimers Dis. 2021;79(3):1195-1201. doi: 10.3233/JAD-201191.
Right temporal variant frontotemporal dementia (rtvFTD) has been generally considered as a right sided variant of semantic variant primary progressive aphasia (svPPA), which is a genetically sporadic disorder. Recently, we have shown that rtvFTD has a unique clinical syndrome compared to svPPA and behavioral variant frontotemporal dementia.
We challenge the assumption that rtvFTD is a sporadic, non-familial variant of FTD by identifying potential autosomal dominant inheritance and related genes in rtvFTD.
We collected all subjects with a diagnosis of FTD or primary progressive aphasia who had undergone genetic screening (n = 284) and subsequently who had a genetic variant (n = 48) with a diagnosis of rtvFTD (n = 6) in 2 specialized memory clinics.
Genetic variants in FTD related genes were found in 33% of genetically screened rtvFTD cases; including MAPT (n = 4), GRN (n = 1), and TARDBP (n = 1) genes, whereas only one svPPA case had a genetic variant in our combined cohorts. Additionally, 4 out of 6 rtvFTD subjects had a strong family history for dementia.
Our results demonstrate that rtvFTD, unlike svPPA, is not a pure sporadic, but a heterogeneous potential genetic variant of FTD, and screening for genetic causes for FTD should be performed in patients with rtvFTD.
右侧颞叶变异型额颞叶痴呆(rtvFTD)通常被认为是语义变异型原发性进行性失语症(svPPA)的右侧变异型,而 svPPA 是一种遗传性散发病。最近,我们发现 rtvFTD 与 svPPA 和行为变异型额颞叶痴呆相比具有独特的临床综合征。
通过鉴定 rtvFTD 中潜在的常染色体显性遗传和相关基因,我们对 rtvFTD 是额颞叶痴呆的散发性、非家族性变异的假设提出质疑。
我们收集了所有在 2 家专门的记忆诊所接受过基因筛查(n=284)并随后被诊断为 rtvFTD(n=6)的额颞叶痴呆或原发性进行性失语症患者,并对其进行了基因检测。
在基因筛查的 rtvFTD 病例中,有 33%发现了额颞叶痴呆相关基因的基因变异,包括 MAPT(n=4)、GRN(n=1)和 TARDBP(n=1)基因,而在我们的联合队列中,仅有 1 例 svPPA 病例存在基因变异。此外,6 例 rtvFTD 患者中有 4 例有明显的痴呆家族史。
我们的结果表明,与 svPPA 不同,rtvFTD 不是一种纯粹的散发性疾病,而是额颞叶痴呆的一种潜在遗传异质性变异型,应在 rtvFTD 患者中进行基因病因筛查。