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Dai S, Qiu L, Veeraraghavan VP, Sheu CL, Mony U. Advances in iPSC Technology in Neural Disease Modeling, Drug Screening, and Therapy. Curr Stem Cell Res Ther 2024; 19:809-819. [PMID: 37291782 DOI: 10.2174/1574888x18666230608105703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 04/16/2023] [Accepted: 05/11/2023] [Indexed: 06/10/2023]
Abstract
Neurodegenerative disorders (NDs) including Alzheimer's Disease, Parkinson's Disease, Amyotrophic Lateral Sclerosis (ALS), and Huntington's disease are all incurable and can only be managed with drugs for the associated symptoms. Animal models of human illnesses help to advance our understanding of the pathogenic processes of diseases. Understanding the pathogenesis as well as drug screening using appropriate disease models of neurodegenerative diseases (NDs) are vital for identifying novel therapies. Human-derived induced pluripotent stem cell (iPSC) models can be an efficient model to create disease in a dish and thereby can proceed with drug screening and identifying appropriate drugs. This technology has many benefits, including efficient reprogramming and regeneration potential, multidirectional differentiation, and the lack of ethical concerns, which open up new avenues for studying neurological illnesses in greater depth. The review mainly focuses on the use of iPSC technology in neuronal disease modeling, drug screening, and cell therapy.
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Affiliation(s)
- Sihan Dai
- Department of Biomedical Engineering, Shantou University, Shantou, 515063, China
| | - Linhui Qiu
- Department of Biomedical Engineering, Shantou University, Shantou, 515063, China
| | - Vishnu Priya Veeraraghavan
- Centre of Molecular Medicine and Diagnostics (COMManD), Department of Biochemistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, 600077, India
| | - Chia-Lin Sheu
- Department of Biomedical Engineering, Shantou University, Shantou, 515063, China
| | - Ullas Mony
- Centre of Molecular Medicine and Diagnostics (COMManD), Department of Biochemistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, 600077, India
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Gambogi LB, Guimarães HC, de Souza LC, Caramelli P. Treatment of the behavioral variant of frontotemporal dementia: a narrative review. Dement Neuropsychol 2021; 15:331-338. [PMID: 34630920 PMCID: PMC8485641 DOI: 10.1590/1980-57642021dn15-030004] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 03/25/2021] [Indexed: 11/22/2022] Open
Abstract
Frontotemporal dementia (FTD) is a progressive neurodegenerative disorder accompanied by behavioral and personality changes and/or language deterioration. Its behavioral variant (bvFTD) is the main clinical presentation. Objective This study aims to investigate the treatment alternatives for bvFTD available so far. Methods We conducted a narrative review of bvFTD treatment options. We used PubMed and Lilacs databases with the terms "frontotemporal dementia" or "behavioral variant frontotemporal dementia" combined with "treatment," "pharmacological treatment," or "disease-modifying drugs." Results The articles retrieved and selected in the research pointed out that there is no specific treatment approved for bvFTD so far. The current proposals are limited to handle the cardinal behavioral symptoms of the disorder. Disease-modifying drugs are under development and may be promising, especially in the monogenic presentations of FTD. Conclusions There are numerous approaches to treat the core symptoms of bvFTD, most of them based on low-quality research. To date, there are no drugs with a disease-specific therapeutic recommendation for bvFTD. Treatments are often investigated guided by primary psychiatric disorders with similar symptoms and should be chosen by the predominant symptom profile.
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Affiliation(s)
- Leandro Boson Gambogi
- Behavioral and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais - Belo Horizonte, MG, Brazil.,Postgraduate Program in Neurosciences, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais - Belo Horizonte, MG, Brazil
| | - Henrique Cerqueira Guimarães
- Behavioral and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais - Belo Horizonte, MG, Brazil
| | - Leonardo Cruz de Souza
- Behavioral and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais - Belo Horizonte, MG, Brazil.,Postgraduate Program in Neurosciences, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais - Belo Horizonte, MG, Brazil
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais - Belo Horizonte, MG, Brazil.,Postgraduate Program in Neurosciences, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais - Belo Horizonte, MG, Brazil
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3
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Fedorova YB. [Current approaches to the treatment of fronto-temporal dementia]. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:18-24. [PMID: 31825385 DOI: 10.17116/jnevro201911909218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Frontotemporal dementias (FTD) are one of the prevalent forms of early neurodegenerative diseases. FTD are characterized by heterogeneous clinical manifestations and syndromes. The current methods of FTD treatment and the clinical trials of new methods of FTD treatment are considered in the article. Biomarkers and their relationships with the results of recently completed clinical trials, as well as future therapeutic perspectives, are reviewed.
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Adaptación y validación de la Frontotemporal Dementia Rating Scale (FTD-FRS) al castellano. Neurologia 2017; 32:290-299. [DOI: 10.1016/j.nrl.2015.12.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 12/06/2015] [Indexed: 11/19/2022] Open
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Adaptation and validation of a Spanish-language version of the Frontotemporal Dementia Rating Scale (FTD-FRS). NEUROLOGÍA (ENGLISH EDITION) 2017. [DOI: 10.1016/j.nrleng.2015.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Li P, Quan W, Zhou YY, Wang Y, Zhang HH, Liu S. Efficacy of memantine on neuropsychiatric symptoms associated with the severity of behavioral variant frontotemporal dementia: A six-month, open-label, self-controlled clinical trial. Exp Ther Med 2016; 12:492-498. [PMID: 27347084 DOI: 10.3892/etm.2016.3284] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 01/29/2016] [Indexed: 12/30/2022] Open
Abstract
Previous studies have focused on the curative effects of memantine in patients with mild-to-moderate frontotemporal lobar degeneration (FTLD); however, its benefits in patients with moderate-to-severe FTLD have not been investigated. The present study explores the behavioral, cognitive and functional effects of memantine on behavioral variant frontotemporal dementia (bvFTD) in patients with mild and moderate-to-severe stage bvFTD. A total of 42 patients with bvFTD completed a 6-month treatment plan of 20 mg memantine daily in an open-label, self-controlled clinical trial. Patients were divided into two groups according to their Mini-Mental State Examination (MMSE) score: Mild (score, 21-26); and moderate-to-severe (score, 4-20). Primary endpoints included Neuropsychiatric Inventory Questionnaire (NPI-Q) and Clinic Dementia Rating (CDR) scores, and secondary endpoints comprised Neuropsychiatric Inventory Caregiver Distress Scale (NPI-D), MMSE, Montreal Cognitive Assessment (MoCA), Activity of Daily Life (ADL) and Hamilton Depression Rating Scale (HAMD) scores. Memantine treatment had no effect on overall NPI-Q scores, with the exception of the agitation subdomain in all patients with bvFTD. However, patients with moderate-to-severe bvFTD exhibited a better performance than patients with mild bvFTD, demonstrated by improved NPI-Q total scores and subscales of agitation, depression, apathy and disinhibition. In the moderate-to-severe group, CDR and HAMD scores remained stable, but MMSE, MoCA and ADL scores were reduced after 6 months of treatment. Memantine was well-tolerated in patients. In conclusion, patients with moderate-to-severe bvFTD responded significantly better to memantine in comparison to patients with mild bvFTD with regard to their neuropsychiatric scores, while memantine did not present any cognitive or functional benefits in patients with mild bvFTD. A randomized, double-blind, placebo-controlled clinical trial with a larger number of patients is required to verify these promising results for patients with moderate-to-severe bvFTD.
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Affiliation(s)
- Pan Li
- Department of Neurology, Tianjin Neurological Institute, Tianjin Huanhu Hospital, Tianjin 300060, P.R. China; Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Tianjin Huanhu Hospital, Tianjin 300060, P.R. China
| | - Wei Quan
- Department of Neurosurgery, Tianjin Medical University, General Hospital, Tianjin 300052, P.R. China; Key Laboratory of Post-trauma Neurorepair and Regeneration in the Central Nervous System, Tianjin Neurological Institute, Ministry of Education, General Hospital, Tianjin 300052, P.R. China; Tianjin Key Laboratory of Injuries, Variations and Regeneration of the Nervous System, General Hospital, Tianjin 300052, P.R. China
| | - Yu-Ying Zhou
- Department of Neurology, Tianjin Neurological Institute, Tianjin Huanhu Hospital, Tianjin 300060, P.R. China; Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Tianjin Huanhu Hospital, Tianjin 300060, P.R. China
| | - Yan Wang
- Department of Neurology, Tianjin Neurological Institute, Tianjin Huanhu Hospital, Tianjin 300060, P.R. China; Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Tianjin Huanhu Hospital, Tianjin 300060, P.R. China
| | - Hui-Hong Zhang
- Department of Neurology, Tianjin Neurological Institute, Tianjin Huanhu Hospital, Tianjin 300060, P.R. China
| | - Shuai Liu
- Department of Neurology, Tianjin Neurological Institute, Tianjin Huanhu Hospital, Tianjin 300060, P.R. China
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Custodio N, Lira D, Herrera-Perez E, Del Prado LN, Parodi J, Guevara-Silva E, Castro-Suarez S, Montesinos R. Cost-of-illness study in a retrospective cohort of patients with dementia in Lima, Peru. Dement Neuropsychol 2015; 9:32-41. [PMID: 29213939 PMCID: PMC5618989 DOI: 10.1590/s1980-57642015dn91000006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Dementia is a major cause of dependency and disability among older persons, and
imposes huge economic burdens. Only a few cost-of-illness studies for dementia
have been carried out in middle and low-income countries.
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Affiliation(s)
- Nilton Custodio
- Servicio de Neurología, Clínica Internacional, Lima, Peru.,Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru.,Servicio de Neurología. Instituto Peruano de Neurociencias, Lima, Peru
| | - David Lira
- Servicio de Neurología, Clínica Internacional, Lima, Peru.,Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru.,Servicio de Neurología. Instituto Peruano de Neurociencias, Lima, Peru
| | - Eder Herrera-Perez
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru.,Centro de Investigación para el Desarrollo Integral y Sostenible (CIDIS), Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Liza Nuñez Del Prado
- Unidad de Diagnóstico de Deterioro Cognitivo y Prevención de Demencia, Instituto Peruano de Neurociencias, Lima, Peru.,Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru.,Servicio de Neurología. Instituto Peruano de Neurociencias, Lima, Peru
| | - José Parodi
- Centro de Investigación del Envejecimiento, Facultad de Medicina Humana, Universidad San Martín de Porres, Lima, Peru
| | | | - Sheila Castro-Suarez
- Unidad de Diagnóstico de Deterioro Cognitivo y Prevención de Demencia, Instituto Peruano de Neurociencias, Lima, Peru.,Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru.,Servicio de Neurología. Instituto Peruano de Neurociencias, Lima, Peru.,Servicio de Neurología de la Conducta, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Rosa Montesinos
- Unidad de Diagnóstico de Deterioro Cognitivo y Prevención de Demencia, Instituto Peruano de Neurociencias, Lima, Peru.,Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru.,Servicio de Medicina Física y Rehabilitación, Clínica Internacional, Lima, Peru
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Fernández-Matarrubia M, Matías-Guiu J, Moreno-Ramos T, Matías-Guiu J. Demencia frontotemporal variante conductual: aproximación clínica y terapéutica. Neurologia 2014; 29:464-72. [DOI: 10.1016/j.nrl.2013.03.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 03/16/2013] [Indexed: 10/26/2022] Open
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Fernández-Matarrubia M, Matías-Guiu J, Moreno-Ramos T, Matías-Guiu J. Behavioural variant frontotemporal dementia: Clinical and therapeutic approaches. NEUROLOGÍA (ENGLISH EDITION) 2014. [DOI: 10.1016/j.nrleng.2013.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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10
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Abstract
Frontotemporal dementia (FTD) is the clinical manifestation of progressive nerve cell loss in the frontal and anterior temporal lobes. It represents the second most frequent form of early-onset dementia. The two major types of FTD are determined by the localisation of the underlying pathology. The behaviour variant is characterised by disinhibition, socially inappropriate manners, loss of empathy, blunting of affect and hyperorality. Key features of the language variant are either non-fluent effortful speech and grammatical errors or impaired word finding and loss of meaning of words and objects. Histopathological changes are characterised by the abnormal processing of proteins including microtubule associated protein Tau, transactive response DNA-binding protein, and tumour-associated protein fused in sarcoma. The familial forms of FTD are caused by mutations in 5 genes. The diagnosis of FTD rests on careful history and psychiatric, neuropsychological and neurological examination supported by laboratory assessments and brain imaging. The management requires an interdisciplinary approach involving the carer and using non-pharmacological approaches in the first line. Current antidementia drugs, including cholinesterase inhibitors and memantine, have no consistent positive effects in FTD. Behavioural symptoms may respond favourably to selective serotonergic antidepressants. Antipsychotic agents should be used with caution regarding motor, cardiovascular and mortality risks.
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11
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Alberici A, Archetti S, Pilotto A, Premi E, Cosseddu M, Bianchetti A, Semeraro F, Salvetti M, Muiesan ML, Padovani A, Borroni B. Results from a pilot study on amiodarone administration in monogenic frontotemporal dementia with granulin mutation. Neurol Sci 2014; 35:1215-9. [PMID: 24569924 DOI: 10.1007/s10072-014-1683-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Accepted: 02/11/2014] [Indexed: 11/30/2022]
Abstract
Frontotemporal dementia (FTD) is one of the most important neurodegenerative conditions and Granulin (GRN) is one of the major genes associated to the disease. FTD-GRN patients are still orphan for any evidence-based target-therapy approach. Interestingly, it has been recently found that alkalizing agents rescued haploinsufficiency in cellular models expressing FTD-GRN mutations. We set up a pilot phase II clinical trial in five FTD patients with GRN Thr272s(g.1977_1980delCACT) mutation, to determine if amiodarone (200 mg/day) may (1) reverse progranulin deficiency and (2) delay disease progression. Each patient was scheduled for 7 study visits over 12 months period. We assessed GRN levels at baseline and after amiodarone administration during the treatment course. Somatic and neurologic examinations, along with cognitive and behavioral assessment were recorded as well. No significant effect on peripheral GRN levels was observed. In treated FTD, disease course did not differ when compared with a group of untreated FTD-GRN patients. This is the first trial targeting progranulin rescue in FTD-GRN patients using amiodarone. Despite the negative findings, it may be interesting to extend this attempt to a larger sample of subjects and to other alkalizing agents to restore granulin haploinsufficiency.
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Affiliation(s)
- A Alberici
- Department of Medical Sciences, Clinic of Neurology, Spedali Civili, University of Brescia, Piazzale Spedali Civili 1, 25100, Brescia, Italy,
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12
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Abstract
Frontotemporal lobar degeneration is an umbrella term for several different disorders. In behavioral variant frontotemporal dementia (bvFTD), patients show deterioration in cognition and social behavior. New diagnostic criteria proposed by the International Behavioral Variant FTD Consortium provide greater sensitivity in diagnosing bvFTD. Current pharmacological management of symptoms relies on medications borrowed from treating Alzheimer's disease (AD) and psychiatric disorders. The evidence for using AD medications such as acetylcholinesterase inhibitors is questionable. Psychiatric medications can be helpful. Trazodone or SSRIs can have some efficacy in reducing disinhibition, repetitive behaviors, sexually inappropriate behaviors, and hyperorality. Small doses of atypical antipsychotics may be helpful in decreasing agitation and verbal outbursts. Nonpharmacological management includes caregiver education and support and behavioral interventions. While symptomatic treatments are likely to remain important behavior management tools, targeting the underlying pathology of bvFTD with disease-modifying agents will hopefully be the future of treatment.
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Abstract
Frontotemporal dementia (FTD) is the second most common type of presenile dementia and is the most common form of dementia with the onset before 60 years of age. Its typical symptoms include behavioral disorders, affective symptoms, and language disorders. The FTD is a genetically and pathologically heterogeneous degenerative disorder. Animal models have provided more insights into the pathogenic mechanisms. There are currently no medications that are specifically approved for the treatment of FTD by the Food and Drug Administration. In this article, we review the recent advances in the molecular pathogenesis, pathology, animal models, and therapy for FTD. Better understanding of the pathogenesis and the use of animal models will help develop novel therapeutic strategies and provide new targets for FTD treatment.
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Affiliation(s)
- Xinling Wang
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Medical Neurobiology of Chinese Ministry of Health, Hangzhou, China
| | - Yuedi Shen
- Center for Cognition and Brain Disorders & The Affiliated Hospital, Hangzhou Normal University School, Hangzhou, China
| | - Wei Chen
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Medical Neurobiology of Chinese Ministry of Health, Hangzhou, China
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