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与突变相关的语义行为变异型额颞叶痴呆和语义性痴呆

Semantic behavioral variant frontotemporal dementia and semantic dementia associated with mutations.

作者信息

Piga Giuseppe, Fadda Laura, Borghero Giuseppe, Maccabeo Alessandra, Pala Francesca, Murru Maria Rita, Giglio Sabrina, Puligheddu Monica, Floris Gianluca

机构信息

Institute of Neurology, Azienda Ospedaliero Universitaria di Cagliari, University of Cagliari, Cagliari, Italy.

Multiple Sclerosis Centre, Binaghi Hospital, ASL Cagliari, University of Cagliari, Cagliari, Italy.

出版信息

Amyotroph Lateral Scler Frontotemporal Degener. 2025 May;26(3-4):358-367. doi: 10.1080/21678421.2024.2439448. Epub 2024 Dec 13.

Abstract

Frontotemporal dementia (FTD) is a highly heritable group of neurodegenerative disorders, characterized by varying clinical and pathological features. gene has been described worldwide within the FTD/ALS spectrum but its association with right and left temporal variant of FTD (tvFTD) is still unclear. This study aimed to reclassify a Sardinian FTD cohort according to proposed criteria for the semantic behavioral variant FTD (sbvFTD), explore mutations' association with tvFTD, and review related literature. From our FTD cohort of 94 patients, ten fulfilled the criteria for sbvFTD. Therefore, in light of the diagnostic reclassification carried out, we describe the largest series of unrelated patients with p.A382T missense mutation, including four new cases of tvFTD: two sbvFTD and two svPPA, exhibiting semantic and behavioral disorders and showing predominant right and left anterior temporal lobe involvement, respectively. We present for the first time two sbvFTD cases carrying the pA382T mutation. Comparison with and non-mutated patients revealed lower age at onset (p = 0.006), and a higher prevalence of tvFTD, particularly sbvFTD (p < 0.001), and motor neuron disease in carriers (p < 0.001). Our findings along with a review of the literature highlighted mutations' association with sbvFTD and semantic dementia, suggesting a genetic role in temporal variants of FTD and emphasizing the need for mutation screening in these cases. Reclassifying FTD cohorts, including the sbvFTD phenotype, could aid in better defining the clinical spectrum of tvFTD and guide differential diagnosis across different FTD populations with or other FTD-related mutations.

摘要

额颞叶痴呆(FTD)是一组具有高度遗传性的神经退行性疾病,其临床和病理特征各异。该基因在全球范围内的FTD/肌萎缩侧索硬化(ALS)谱系中均有报道,但其与FTD左右颞叶变异型(tvFTD)的关联仍不明确。本研究旨在根据语义行为变异型FTD(sbvFTD)的既定标准对撒丁岛FTD队列进行重新分类,探讨该突变与tvFTD的关联,并回顾相关文献。在我们94例患者的FTD队列中,有10例符合sbvFTD标准。因此,鉴于进行的诊断重新分类,我们描述了最大系列的携带p.A382T错义突变的无关患者,包括4例tvFTD新病例:2例sbvFTD和2例语义变异型原发性进行性失语(svPPA),分别表现出语义和行为障碍,并分别显示主要累及右侧和左侧颞叶前部。我们首次报告了2例携带pA382T突变的sbvFTD病例。与非突变患者比较发现,携带者发病年龄较低(p = 0.006),tvFTD患病率较高,尤其是sbvFTD(p < 0.001),以及运动神经元病患病率较高(p < 0.001)。我们的研究结果以及文献回顾突出了该突变与sbvFTD和语义性痴呆的关联,提示其在FTD颞叶变异型中的遗传作用,并强调在这些病例中进行该突变筛查的必要性。对FTD队列进行重新分类,包括sbvFTD表型,有助于更好地界定tvFTD的临床谱,并指导对携带该突变或其他与FTD相关突变的不同FTD人群进行鉴别诊断。

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