Soppela Helmi, Krüger Johanna, Hartikainen Päivi, Koivisto Anne, Haapasalo Annakaisa, Borroni Barbara, Remes Anne M, Katisko Kasper, Solje Eino
Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland.
Research Unit of Clinical Neuroscience, Neurology, University of Oulu, Oulu, Finland.
J Alzheimers Dis. 2023;91(1):225-232. doi: 10.3233/JAD-220545.
Currently, there are few studies considering possible modifiable risk factors of frontotemporal dementia (FTD).
In this retrospective case-control study, we evaluated whether a history of traumatic brain injury (TBI) associates with a diagnosis of FTD or modulates the clinical phenotype or onset age in FTD patients.
We compared the prevalence of prior TBI between individuals with FTD (N = 218) and age and sex-matched AD patients (N = 214) or healthy controls (HC; N = 100). Based on the patient records, an individual was categorized to the TBI+ group if they were reported to have suffered from TBI during lifetime. The possible associations of TBI with age of onset and disease duration were also evaluated in the whole FTD patient group or separately in the sporadic and genetic FTD groups.
The prevalence of previous TBI was the highest in the FTD group (19.3%) when compared to the AD group (13.1%, p = 0.050) or HC group (12%, p = 0.108, not significant). Preceding TBI was more often associated with the sporadic FTD cases than the C9orf72 repeat expansion-carrying FTD cases (p = 0.003). Furthermore, comparison of the TBI+ and TBI- FTD groups indicated that previous TBI was associated with an earlier onset age in the FTD patients (B = 3.066, p = 0.010).
A preceding TBI associates especially with sporadic FTD and with earlier onset of symptoms. The results of this study suggest that TBI may be a triggering factor for the neurodegenerative processes in FTD. However, understanding the precise underlying mechanisms still needs further studies.
目前,很少有研究考虑额颞叶痴呆(FTD)可能的可改变风险因素。
在这项回顾性病例对照研究中,我们评估了创伤性脑损伤(TBI)病史是否与FTD诊断相关,或是否调节FTD患者的临床表型或发病年龄。
我们比较了FTD患者(N = 218)与年龄和性别匹配的AD患者(N = 214)或健康对照(HC;N = 100)中既往TBI的患病率。根据患者记录,如果报告个体一生中曾遭受TBI,则将其归类为TBI+组。还在整个FTD患者组中或分别在散发性和遗传性FTD组中评估了TBI与发病年龄和疾病持续时间的可能关联。
与AD组(13.1%,p = 0.050)或HC组(12%,p = 0.108,无统计学意义)相比,FTD组中既往TBI的患病率最高(19.3%)。与携带C9orf72重复扩增的FTD病例相比,既往TBI更常与散发性FTD病例相关(p = 0.003)。此外,TBI+和TBI-FTD组的比较表明,既往TBI与FTD患者较早的发病年龄相关(B = 3.066,p = 0.010)。
既往TBI尤其与散发性FTD以及较早出现症状相关。本研究结果表明,TBI可能是FTD神经退行性过程的触发因素。然而,了解确切的潜在机制仍需要进一步研究。