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Steinmetz S, Vandecasteele L, Lebert F, Voorpostel M, Lipps O. The gendered consequences of the COVID-19 lockdown on unpaid work in Swiss dual earner couples with children. Gend Work Organ 2022; 29:GWAO12875. [PMID: 35942420 PMCID: PMC9350281 DOI: 10.1111/gwao.12875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/28/2022] [Accepted: 05/13/2022] [Indexed: 11/30/2022]
Abstract
This article assesses the gendered impact of COVID-19 measures on changes in time that Swiss dual earner couples spent on unpaid work during the pandemic, focusing on families with children. Overcoming some of the methodological shortcomings of previous studies, high-quality representative panel data allow us to examine the change in time invested in housework and childcare before and during the pandemic, and test theoretical assumptions as to the mechanisms underlying the observed patterns. Gender inequalities are explained by the couple's work division prior to, and at the onset of, the pandemic and interpreted in the light of key theoretical approaches (economics of the family, bargaining and time availability, doing gender). Our results imply that in particular changes in the time availability of the partner are relevant for changes in time spent on housework, while in case of care work, the own time availability matters more. Moreover, we also found that the respondents' economic bargaining power within the couple matters both for housework and care work. Finally, the implemented COVID-19 measures neither led to an increase in patriarchal power structures nor did they foster an increase in equality for unpaid work among women and men. Instead, the results show that changes in time availability due to short-time, remote or overtime working schemes determined changes in time spent on unpaid care to a larger extent than gender alone.
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Affiliation(s)
- Stephanie Steinmetz
- University of LausanneLausanneSwitzerland
- University of AmsterdamAmsterdamThe Netherlands
| | | | - Florence Lebert
- FORS – Swiss Centre of Expertise in the Social SciencesLausanneSwitzerland
| | - Marieke Voorpostel
- FORS – Swiss Centre of Expertise in the Social SciencesLausanneSwitzerland
| | - Oliver Lipps
- FORS – Swiss Centre of Expertise in the Social SciencesLausanneSwitzerland
- University of BernBernSwitzerland
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Leroy M, Bertoux M, Skrobala E, Mode E, Adnet-Bonte C, Le Ber I, Bombois S, Cassagnaud P, Chen Y, Deramecourt V, Lebert F, Mackowiak MA, Sillaire AR, Wathelet M, Pasquier F, Lebouvier T. Characteristics and progression of patients with frontotemporal dementia in a regional memory clinic network. Alzheimers Res Ther 2021; 13:19. [PMID: 33419472 PMCID: PMC7796569 DOI: 10.1186/s13195-020-00753-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 12/16/2020] [Indexed: 12/11/2022]
Abstract
Background Due to heterogeneous clinical presentation, difficult differential diagnosis with Alzheimer’s disease (AD) and psychiatric disorders, and evolving clinical criteria, the epidemiology and natural history of frontotemporal lobar degeneration (FTD) remain elusive. In order to better characterize FTD patients, we relied on the database of a regional memory clinic network with standardized diagnostic procedures and chose AD patients as a comparator. Methods Patients that were first referred to our network between January 2010 and December 2016 and whose last clinical diagnosis was degenerative or vascular dementia were included. Comparisons were conducted between FTD and AD as well as between the different FTD syndromes, divided into language variants (lvFTD), behavioral variant (bvFTD), and FTD with primarily motor symptoms (mFTD). Cognitive progression was estimated with the yearly decline in Mini Mental State Examination (MMSE). Results Among the patients that were referred to our network in the 6-year time span, 690 were ultimately diagnosed with FTD and 18,831 with AD. Patients with FTD syndromes represented 2.6% of all-cause dementias. The age-standardized incidence was 2.90 per 100,000 person-year and incidence peaked between 75 and 79 years. Compared to AD, patients with FTD syndromes had a longer referral delay and delay to diagnosis. Patients with FTD syndromes had a higher MMSE score than AD at first referral while their progression was similar. mFTD patients had the shortest survival while survival in bvFTD, lvFTD, and AD did not significantly differ. FTD patients, especially those with the behavioral variant, received more antidepressants, anxiolytics, and antipsychotics than AD patients. Conclusions FTD syndromes differ with AD in characteristics at baseline, progression rate, and treatment. Despite a broad use of the new diagnostic criteria in an organized memory clinic network, FTD syndromes are longer to diagnose and account for a low proportion of dementia cases, suggesting persistent underdiagnosis. Congruent with recent publications, the late peak of incidence warns against considering FTD as being exclusively a young-onset dementia.
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Affiliation(s)
- Mélanie Leroy
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, CNRMAJ, LiCEND, DistAlz, F-59000, Lille, France
| | - Maxime Bertoux
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, CNRMAJ, LiCEND, DistAlz, F-59000, Lille, France
| | | | - Elisa Mode
- Univ. Lille, Inserm, CHU Lille, F-59000, Lille, France
| | - Catherine Adnet-Bonte
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, CNRMAJ, LiCEND, DistAlz, F-59000, Lille, France
| | - Isabelle Le Ber
- Sorbonne Université, Inserm U1127, CNRS UMR 7225, Institut du Cerveau (ICM), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France.,Centre de référence des démences rares ou précoces, IM2A, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France
| | - Stéphanie Bombois
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, CNRMAJ, LiCEND, DistAlz, F-59000, Lille, France
| | - Pascaline Cassagnaud
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, CNRMAJ, LiCEND, DistAlz, F-59000, Lille, France
| | - Yaohua Chen
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, CNRMAJ, LiCEND, DistAlz, F-59000, Lille, France
| | - Vincent Deramecourt
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, CNRMAJ, LiCEND, DistAlz, F-59000, Lille, France
| | - Florence Lebert
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, CNRMAJ, LiCEND, DistAlz, F-59000, Lille, France
| | - Marie Anne Mackowiak
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, CNRMAJ, LiCEND, DistAlz, F-59000, Lille, France
| | - Adeline Rollin Sillaire
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, CNRMAJ, LiCEND, DistAlz, F-59000, Lille, France
| | | | - Florence Pasquier
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, CNRMAJ, LiCEND, DistAlz, F-59000, Lille, France
| | - Thibaud Lebouvier
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, CNRMAJ, LiCEND, DistAlz, F-59000, Lille, France.
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Lecerf S, Leroy M, Lebouvier T, Lebert F, Deramecourt V, Maurage CA, Pasquier F. Alzheimer's disease phenotypes misdiagnosed with frontotemporal lobar degeneration: A retrospective neuropathologic study. Alzheimers Dement 2020. [DOI: 10.1002/alz.039692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Simon Lecerf
- University of Lille, CHU, Inserm U1172, Distalz Lille France
| | - Melanie Leroy
- University of Lille, Inserm, CHU‐Lille, Lille Neuroscience & Cognition F‐59000 Lille France
| | - Thibaud Lebouvier
- University of Lille, Inserm, CHU‐Lille, Lille Neuroscience & Cognition F‐59000 Lille France
| | - Florence Lebert
- University of Lille, Inserm 1172, CHU, Licend, Distalz Lille France
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Lebert F, Thomas-Antérion C. Frontal ou “Frontal” ? Formes comportementales de DFLT. Rev Neurol (Paris) 2020. [DOI: 10.1016/j.neurol.2020.01.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bertoux M, Cassagnaud P, Lebouvier T, Lebert F, Sarazin M, Le Ber I, Dubois B, Auriacombe S, Hannequin D, Wallon D, Ceccaldi M, Maurage CA, Deramecourt V, Pasquier F. Does amnesia specifically predict Alzheimer's pathology? A neuropathological study. Neurobiol Aging 2020; 95:123-130. [PMID: 32795849 DOI: 10.1016/j.neurobiolaging.2020.07.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 07/10/2020] [Accepted: 07/14/2020] [Indexed: 12/14/2022]
Abstract
Amnesia is a key component of Alzheimer's disease (AD) and the most important feature of its clinical diagnosis but its specificity has recently been challenged. This study investigated the ability of amnesia to predict AD in a clinicopathological dementia series. Ninety-one patients to which free and cued verbal memory assessment was administered during early cognitive decline, were followed until autopsy. Patients' histological diagnoses were classified as pure AD, mixed AD, and non-AD pathologies. Data-driven automated classification procedures explored the correspondence between memory performance and pathological diagnoses. Classifications revealed 3 clusters of performance reflecting different levels of amnesia. Little correspondence between these clusters and the presence of AD pathology was retrieved. A third of patients with pure/mixed AD pathology were non-amnesic at presentation and ≈45% of patients without AD pathology were amnesic. Data-driven prediction of AD pathology based on memory also had a poor accuracy. Free and cued memory assessments are fair tools to diagnose an amnesic syndrome but lack accuracy to predict AD pathology.
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Affiliation(s)
- Maxime Bertoux
- Univ Lille, Lille Neuroscience & Cognition (Inserm UMRS1172) Degenerative and Vascular Cognitive Disorders, CHU Lille, Laboratory of Excellence Distalz (Development of Innovative Strategies for a Transdisciplinary approach to ALZheimer's disease), Lille, France.
| | - Pascaline Cassagnaud
- Univ Lille, CHU Lille, Laboratory of Excellence Distalz (Development of Innovative Strategies for a Transdisciplinary approach to ALZheimer's disease), Lille, France
| | - Thibaud Lebouvier
- Univ Lille, Lille Neuroscience & Cognition (Inserm UMRS1172) Alzheimer & Tauopathies, CHU Lille, Laboratory of Excellence Distalz (Development of Innovative Strategies for a Transdisciplinary approach to ALZheimer's disease), Lille, France
| | - Florence Lebert
- Univ Lille, Lille Neuroscience & Cognition (Inserm UMRS1172) Degenerative and Vascular Cognitive Disorders, CHU Lille, Laboratory of Excellence Distalz (Development of Innovative Strategies for a Transdisciplinary approach to ALZheimer's disease), Lille, France
| | - Marie Sarazin
- Unit of Neurology of Memory and Language, GHU-Paris Psychiatrie et Neurosciences, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; UMR 1023 IMIV, Service Hospitalier Frédéric Joliot, CEA, Inserm, Université Paris Sud, CNRS, Université Paris-Saclay, Orsay, France
| | - Isabelle Le Ber
- Brain & Spine Institute, UMR 975, Paris, France; Neurology Department, CHU Pitié-Salpêtrière, IM2A, Paris, France
| | - Bruno Dubois
- Brain & Spine Institute, UMR 975, Paris, France; Neurology Department, CHU Pitié-Salpêtrière, IM2A, Paris, France
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- Brain & Spine Institute, UMR 975, Paris, France
| | | | - Didier Hannequin
- Neurology Department, Univ Rouen, CHU Charles Nicolle, Rouen, France
| | - David Wallon
- Neurology Department, Univ Rouen, CHU Charles Nicolle, Rouen, France
| | - Mathieu Ceccaldi
- Neurology and Neuropsychology Department, CHU La Timone, Marseille, France
| | - Claude-Alain Maurage
- Univ Lille, Lille Neuroscience & Cognition (Inserm UMRS1172), Development and Plasticity of the Neuroendocrine Brain, Lille, France; Department of Neuropathology, Univ Lille, CHU Lille, Lille, France
| | - Vincent Deramecourt
- Univ Lille, Lille Neuroscience & Cognition (Inserm UMRS1172) Alzheimer & Tauopathies, CHU Lille, Laboratory of Excellence Distalz (Development of Innovative Strategies for a Transdisciplinary approach to ALZheimer's disease), Lille, France; Department of Neuropathology, Univ Lille, CHU Lille, Lille, France
| | - Florence Pasquier
- Univ Lille, Lille Neuroscience & Cognition (Inserm UMRS1172) Degenerative and Vascular Cognitive Disorders, CHU Lille, Laboratory of Excellence Distalz (Development of Innovative Strategies for a Transdisciplinary approach to ALZheimer's disease), Lille, France
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De Reuck JL, Auger F, Durieux N, Cordonnier C, Deramecourt V, Lebert F, Leys D, Pasquier F, Maurage CA, Bordet R. Detection of Cortical Microbleeds in Postmortem Brains of Patients with Lewy Body Dementia: A 7.0-Tesla Magnetic Resonance Imaging Study with Neuropathological Correlates. Eur Neurol 2015; 74:158-61. [DOI: 10.1159/000441057] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 09/13/2015] [Indexed: 11/19/2022]
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Boutoleau-Bretonnière C, Evrard C, Hardouin JB, Rocher L, Charriau T, Etcharry-Bouyx F, Auriacombe S, Richard-Mornas A, Lebert F, Pasquier F, Sauvaget A, Bulteau S, Vercelletto M, Derkinderen P, Bretonnière C, Thomas-Antérion C. DAPHNE: A New Tool for the Assessment of the Behavioral Variant of Frontotemporal Dementia. Dement Geriatr Cogn Dis Extra 2015; 5:503-16. [PMID: 26955383 PMCID: PMC4777961 DOI: 10.1159/000440859] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The diagnosis of behavioral variant of frontotemporal dementia (bvFTD) relies primarily on clinical features and remains challenging. The specificity of the recently revised criteria can be disappointing, justifying development of new clinical tools. OBJECTIVE We produced a behavioral inventory named DAPHNE. This scale (adapted from Rascovsky's criteria) explores six domains: disinhibition, apathy, perseverations, hyperorality, personal neglect and loss of empathy. It is composed of ten items (five answer categories). The aim was (1) to assess the validity and reliability of DAPHNE and (2) to evaluate its contribution in differentiating patients. METHODS Two scores were computed: DAPHNE-6 (screening) from the six domains and DAPHNE-40 (diagnosis) from the ten items. Reliability and reproducibility were assessed. External validity was studied with the Frontal Behavioral Inventory (FBI) and the Frontotemporal Behavioral Scale (FBS). Finally, the diagnostic performance of DAPHNE was compared to revised criteria, FBI and FBS. RESULTS DAPHNE was administered to the caregivers of 89 patients, 36 with bvFTD, 22 with Alzheimer's disease, 15 with progressive supranuclear palsy and 16 with bipolar disorder. Reliability and reproducibility were excellent, as was external validity. DAPHNE-6 allowed bvFTD diagnosis (score ≥4) with a sensitivity of 92%, while DAPHNE-40 (score ≥15) had a specificity of 92%. CONCLUSION We demonstrate excellent psychometric features for DAPHNE. This quick tool could help for both diagnosing and screening bvFTD.
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Affiliation(s)
- Claire Boutoleau-Bretonnière
- CHU Nantes, Centre Mémoire Ressource et Recherche, Département de Neurologie, Université de Nantes, France
- INSERM CIC 04, Université de Nantes, France
- Laboratoire d'Etudes des Mécanismes Cognitifs, EA 3082, Université Lyon 2, Bron, Lyon, France
| | - Christelle Evrard
- CHU Nantes, Centre Mémoire Ressource et Recherche, Département de Neurologie, Université de Nantes, France
- INSERM CIC 04, Université de Nantes, France
| | - Jean Benoît Hardouin
- EA 4275, Biostatistics, Pharmacoepidemiology and Human Sciences Research Team, Université de Nantes, France
- CHU Nantes, Département de Méthodologie et Biostatistiques, Université de Nantes, Nantes, France
| | - Laëtitia Rocher
- CHU Nantes, Centre Mémoire Ressource et Recherche, Département de Neurologie, Université de Nantes, France
- INSERM CIC 04, Université de Nantes, France
| | - Tiphaine Charriau
- CHU Nantes, Centre Mémoire Ressource et Recherche, Département de Neurologie, Université de Nantes, France
- INSERM CIC 04, Université de Nantes, France
| | | | - Sophie Auriacombe
- Centre Mémoire Ressource et Recherche, Département de Neurologie, CHU Bordeaux, Bordeaux, Lyon, France
| | | | - Florence Lebert
- Centre Mémoire Ressource et Recherche, Département de Neurologie, CHU Lille, Lille, Lyon, France
| | - Florence Pasquier
- Centre Mémoire Ressource et Recherche, Département de Neurologie, CHU Lille, Lille, Lyon, France
| | - Anne Sauvaget
- CAPPA Jacques Prévert Unité ECT-TMS-Liaison, UIC 18 ‘Addictions Comportementales et Troubles de l'Humeur Complexes', Service d'Addictologie et Psychiatrie de Liaison, CHU Nantes, Université de Nantes, Nantes, France
| | - Samuel Bulteau
- CAPPA Jacques Prévert Unité ECT-TMS-Liaison, UIC 18 ‘Addictions Comportementales et Troubles de l'Humeur Complexes', Service d'Addictologie et Psychiatrie de Liaison, CHU Nantes, Université de Nantes, Nantes, France
| | - Martine Vercelletto
- CHU Nantes, Centre Mémoire Ressource et Recherche, Département de Neurologie, Université de Nantes, France
- INSERM CIC 04, Université de Nantes, France
| | - Pascal Derkinderen
- CHU Nantes, Centre Mémoire Ressource et Recherche, Département de Neurologie, Université de Nantes, France
- INSERM, UMR 913, Université de Nantes, Nantes, France
| | - Cédric Bretonnière
- EA3826, Thérapeutiques Cliniques et Expérimentales des Infections, UFR Médecine, Université de Nantes, Nantes, France
| | - Catherine Thomas-Antérion
- Laboratoire d'Etudes des Mécanismes Cognitifs, EA 3082, Université Lyon 2, Bron, Lyon, France
- Plein-Ciel, Lyon, France
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Ferrari R, Hernandez DG, Nalls MA, Rohrer JD, Ramasamy A, Kwok JBJ, Dobson-Stone C, Brooks WS, Schofield PR, Halliday GM, Hodges JR, Piguet O, Bartley L, Thompson E, Haan E, Hernández I, Ruiz A, Boada M, Borroni B, Padovani A, Cruchaga C, Cairns NJ, Benussi L, Binetti G, Ghidoni R, Forloni G, Galimberti D, Fenoglio C, Serpente M, Scarpini E, Clarimón J, Lleó A, Blesa R, Waldö ML, Nilsson K, Nilsson C, Mackenzie IRA, Hsiung GYR, Mann DMA, Grafman J, Morris CM, Attems J, Griffiths TD, McKeith IG, Thomas AJ, Pietrini P, Huey ED, Wassermann EM, Baborie A, Jaros E, Tierney MC, Pastor P, Razquin C, Ortega-Cubero S, Alonso E, Perneczky R, Diehl-Schmid J, Alexopoulos P, Kurz A, Rainero I, Rubino E, Pinessi L, Rogaeva E, St George-Hyslop P, Rossi G, Tagliavini F, Giaccone G, Rowe JB, Schlachetzki JCM, Uphill J, Collinge J, Mead S, Danek A, Van Deerlin VM, Grossman M, Trojanowski JQ, van der Zee J, Deschamps W, Van Langenhove T, Cruts M, Van Broeckhoven C, Cappa SF, Le Ber I, Hannequin D, Golfier V, Vercelletto M, Brice A, Nacmias B, Sorbi S, Bagnoli S, Piaceri I, Nielsen JE, Hjermind LE, Riemenschneider M, Mayhaus M, Ibach B, Gasparoni G, Pichler S, Gu W, Rossor MN, Fox NC, Warren JD, Spillantini MG, Morris HR, Rizzu P, Heutink P, Snowden JS, Rollinson S, Richardson A, Gerhard A, Bruni AC, Maletta R, Frangipane F, Cupidi C, Bernardi L, Anfossi M, Gallo M, Conidi ME, Smirne N, Rademakers R, Baker M, Dickson DW, Graff-Radford NR, Petersen RC, Knopman D, Josephs KA, Boeve BF, Parisi JE, Seeley WW, Miller BL, Karydas AM, Rosen H, van Swieten JC, Dopper EGP, Seelaar H, Pijnenburg YAL, Scheltens P, Logroscino G, Capozzo R, Novelli V, Puca AA, Franceschi M, Postiglione A, Milan G, Sorrentino P, Kristiansen M, Chiang HH, Graff C, Pasquier F, Rollin A, Deramecourt V, Lebert F, Kapogiannis D, Ferrucci L, Pickering-Brown S, Singleton AB, Hardy J, Momeni P. Frontotemporal dementia and its subtypes: a genome-wide association study. Lancet Neurol 2014; 13:686-99. [PMID: 24943344 PMCID: PMC4112126 DOI: 10.1016/s1474-4422(14)70065-1] [Citation(s) in RCA: 233] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Frontotemporal dementia (FTD) is a complex disorder characterised by a broad range of clinical manifestations, differential pathological signatures, and genetic variability. Mutations in three genes-MAPT, GRN, and C9orf72--have been associated with FTD. We sought to identify novel genetic risk loci associated with the disorder. METHODS We did a two-stage genome-wide association study on clinical FTD, analysing samples from 3526 patients with FTD and 9402 healthy controls. To reduce genetic heterogeneity, all participants were of European ancestry. In the discovery phase (samples from 2154 patients with FTD and 4308 controls), we did separate association analyses for each FTD subtype (behavioural variant FTD, semantic dementia, progressive non-fluent aphasia, and FTD overlapping with motor neuron disease [FTD-MND]), followed by a meta-analysis of the entire dataset. We carried forward replication of the novel suggestive loci in an independent sample series (samples from 1372 patients and 5094 controls) and then did joint phase and brain expression and methylation quantitative trait loci analyses for the associated (p<5 × 10(-8)) single-nucleotide polymorphisms. FINDINGS We identified novel associations exceeding the genome-wide significance threshold (p<5 × 10(-8)). Combined (joint) analyses of discovery and replication phases showed genome-wide significant association at 6p21.3, HLA locus (immune system), for rs9268877 (p=1·05 × 10(-8); odds ratio=1·204 [95% CI 1·11-1·30]), rs9268856 (p=5·51 × 10(-9); 0·809 [0·76-0·86]) and rs1980493 (p value=1·57 × 10(-8), 0·775 [0·69-0·86]) in the entire cohort. We also identified a potential novel locus at 11q14, encompassing RAB38/CTSC (the transcripts of which are related to lysosomal biology), for the behavioural FTD subtype for which joint analyses showed suggestive association for rs302668 (p=2·44 × 10(-7); 0·814 [0·71-0·92]). Analysis of expression and methylation quantitative trait loci data suggested that these loci might affect expression and methylation in cis. INTERPRETATION Our findings suggest that immune system processes (link to 6p21.3) and possibly lysosomal and autophagy pathways (link to 11q14) are potentially involved in FTD. Our findings need to be replicated to better define the association of the newly identified loci with disease and to shed light on the pathomechanisms contributing to FTD. FUNDING The National Institute of Neurological Disorders and Stroke and National Institute on Aging, the Wellcome/MRC Centre on Parkinson's disease, Alzheimer's Research UK, and Texas Tech University Health Sciences Center.
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Affiliation(s)
- Raffaele Ferrari
- Laboratory of Neurogenetics, Department of Internal Medicine, Texas Tech University Health Science Center, Lubbock, Texas, USA; Reta Lila Weston Research Laboratories, Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - Dena G Hernandez
- Reta Lila Weston Research Laboratories, Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK; Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Michael A Nalls
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Jonathan D Rohrer
- Reta Lila Weston Research Laboratories, Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK; Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK
| | - Adaikalavan Ramasamy
- Reta Lila Weston Research Laboratories, Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK; Department of Medical and Molecular Genetics, King's College London, Guy's Hospital, London, UK
| | - John B J Kwok
- Neuroscience Research Australia, Sydney, NSW, Australia; University of New South Wales, Sydney, NSW, Australia
| | - Carol Dobson-Stone
- Neuroscience Research Australia, Sydney, NSW, Australia; University of New South Wales, Sydney, NSW, Australia
| | - William S Brooks
- Neuroscience Research Australia, Sydney, NSW, Australia; University of New South Wales, Sydney, NSW, Australia
| | - Peter R Schofield
- Neuroscience Research Australia, Sydney, NSW, Australia; University of New South Wales, Sydney, NSW, Australia
| | - Glenda M Halliday
- Neuroscience Research Australia, Sydney, NSW, Australia; University of New South Wales, Sydney, NSW, Australia
| | - John R Hodges
- Neuroscience Research Australia, Sydney, NSW, Australia; University of New South Wales, Sydney, NSW, Australia
| | - Olivier Piguet
- Neuroscience Research Australia, Sydney, NSW, Australia; University of New South Wales, Sydney, NSW, Australia
| | | | - Elizabeth Thompson
- South Australian Clinical Genetics Service, SA Pathology at Women's and Children's Hospital, North Adelaide, SA, Australia; Department of Paediatrics, University of Adelaide, Adelaide, SA, Australia
| | - Eric Haan
- South Australian Clinical Genetics Service, SA Pathology at Women's and Children's Hospital, North Adelaide, SA, Australia; Department of Paediatrics, University of Adelaide, Adelaide, SA, Australia
| | - Isabel Hernández
- Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
| | - Agustín Ruiz
- Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
| | - Mercè Boada
- Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain; Hospital Universitari Vall d'Hebron-Institut de Recerca, Universitat Autonoma de Barcelona (VHIR-UAB), Barcelona, Spain
| | | | | | - Carlos Cruchaga
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri, USA; Hope Center, Washington University School of Medicine, St Louis, Missouri, USA
| | - Nigel J Cairns
- Hope Center, Washington University School of Medicine, St Louis, Missouri, USA; Department of Pathology and Immunology, Washington University, St Louis, Missouri, USA
| | - Luisa Benussi
- NeuroBioGen Lab-Memory Clinic, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Giuliano Binetti
- NeuroBioGen Lab-Memory Clinic, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Roberta Ghidoni
- Proteomics Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Gianluigi Forloni
- Biology of Neurodegenerative Disorders, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy
| | - Daniela Galimberti
- University of Milan, Milan, Italy; Fondazione Cà Granda, IRCCS Ospedale Maggiore Policlinico, Milan, Italy
| | - Chiara Fenoglio
- University of Milan, Milan, Italy; Fondazione Cà Granda, IRCCS Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Serpente
- University of Milan, Milan, Italy; Fondazione Cà Granda, IRCCS Ospedale Maggiore Policlinico, Milan, Italy
| | - Elio Scarpini
- University of Milan, Milan, Italy; Fondazione Cà Granda, IRCCS Ospedale Maggiore Policlinico, Milan, Italy
| | - Jordi Clarimón
- Memory Unit, Neurology Department and Sant Pau Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; Center for Networker Biomedical Research in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Alberto Lleó
- Memory Unit, Neurology Department and Sant Pau Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; Center for Networker Biomedical Research in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Rafael Blesa
- Memory Unit, Neurology Department and Sant Pau Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; Center for Networker Biomedical Research in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Maria Landqvist Waldö
- Unit of Geriatric Psychiatry, Department of Clinical Sciences, Lund University, Sweden
| | - Karin Nilsson
- Unit of Geriatric Psychiatry, Department of Clinical Sciences, Lund University, Sweden
| | - Christer Nilsson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Sweden
| | - Ian R A Mackenzie
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Ging-Yuek R Hsiung
- Division of Neurology, University of British Columbia, Vancouver, Canada
| | - David M A Mann
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Salford Royal Hospital, Stott Lane, Salford, UK
| | - Jordan Grafman
- Rehabilitation Institute of Chicago, Departments of Physical Medicine and Rehabilitation, Psychiatry, and Cognitive Neurology and Alzheimer's Disease Center, IL, USA; Feinberg School of Medicine, Northwestern University, IL, USA; Department of Psychology, Weinberg College of Arts and Sciences, Northwestern University, IL, USA
| | - Christopher M Morris
- Rehabilitation Institute of Chicago, Departments of Physical Medicine and Rehabilitation, Psychiatry, and Cognitive Neurology and Alzheimer's Disease Center, IL, USA; Feinberg School of Medicine, Northwestern University, IL, USA; Newcastle Brain Tissue Resource, Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, UK; Newcastle University, Institute for Ageing and Health, Campus for Ageing and Vitality, Newcastle upon Tyne, UK; Institute of Neuroscience, Newcastle University Medical School, Newcastle upon Tyne, UK
| | - Johannes Attems
- Rehabilitation Institute of Chicago, Departments of Physical Medicine and Rehabilitation, Psychiatry, and Cognitive Neurology and Alzheimer's Disease Center, IL, USA; Feinberg School of Medicine, Northwestern University, IL, USA; Newcastle Brain Tissue Resource, Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, UK; Newcastle University, Institute for Ageing and Health, Campus for Ageing and Vitality, Newcastle upon Tyne, UK
| | - Timothy D Griffiths
- Rehabilitation Institute of Chicago, Departments of Physical Medicine and Rehabilitation, Psychiatry, and Cognitive Neurology and Alzheimer's Disease Center, IL, USA; Feinberg School of Medicine, Northwestern University, IL, USA; Newcastle Brain Tissue Resource, Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, UK; Institute of Neuroscience, Newcastle University Medical School, Newcastle upon Tyne, UK
| | - Ian G McKeith
- Biomedical Research Building, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - Alan J Thomas
- Newcastle University, Institute for Ageing and Health, Campus for Ageing and Vitality, Newcastle upon Tyne, UK
| | - P Pietrini
- Clinical Psychology Branch, Pisa University Hospital, Pisa, Italy; Laboratory of Clinical Biochemistry and Molecular Biology, University of Pisa, Pisa, Italy
| | - Edward D Huey
- Taub Institute, Departments of Psychiatry and Neurology, Columbia University, New York, NY, USA 10032
| | - Eric M Wassermann
- Behavioral Neurology Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Atik Baborie
- Neuropathology Department, Walton Centre FT, Liverpool, UK
| | - Evelyn Jaros
- Newcastle University, Institute for Ageing and Health, Campus for Ageing and Vitality, Newcastle upon Tyne, UK; Neuropathology/Cellular Pathology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Michael C Tierney
- Behavioral Neurology Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Pau Pastor
- Center for Networker Biomedical Research in Neurodegenerative Diseases (CIBERNED), Madrid, Spain; Neurogenetics Laboratory, Division of Neurosciences, Center for Applied Medical Research, Universidad de Navarra, Pamplona, Spain; Department of Neurology, Clínica Universidad de Navarra, University of Navarra School of Medicine, Pamplona, Spain
| | - Cristina Razquin
- Neurogenetics Laboratory, Division of Neurosciences, Center for Applied Medical Research, Universidad de Navarra, Pamplona, Spain
| | - Sara Ortega-Cubero
- Center for Networker Biomedical Research in Neurodegenerative Diseases (CIBERNED), Madrid, Spain; Neurogenetics Laboratory, Division of Neurosciences, Center for Applied Medical Research, Universidad de Navarra, Pamplona, Spain
| | - Elena Alonso
- Neurogenetics Laboratory, Division of Neurosciences, Center for Applied Medical Research, Universidad de Navarra, Pamplona, Spain
| | - Robert Perneczky
- Neuroepidemiology and Ageing Research Unit, School of Public Health, Faculty of Medicine, The Imperial College of Science, Technology and Medicine, London, UK; West London Cognitive Disorders Treatment and Research Unit, West London Mental Health Trust, London TW8 8 DS, UK; Department of Psychiatry and Psychotherapy, Technische Universität München, Munich, Germany
| | - Janine Diehl-Schmid
- Department of Psychiatry and Psychotherapy, Technische Universität München, Munich, Germany
| | - Panagiotis Alexopoulos
- Department of Psychiatry and Psychotherapy, Technische Universität München, Munich, Germany
| | - Alexander Kurz
- Department of Psychiatry and Psychotherapy, Technische Universität München, Munich, Germany
| | - Innocenzo Rainero
- Neurology I, Department of Neuroscience, University of Torino, Italy; AO Città della Salute e della Scienza di Torino, Italy
| | - Elisa Rubino
- Neurology I, Department of Neuroscience, University of Torino, Italy; AO Città della Salute e della Scienza di Torino, Italy
| | - Lorenzo Pinessi
- Neurology I, Department of Neuroscience, University of Torino, Italy; AO Città della Salute e della Scienza di Torino, Italy
| | - Ekaterina Rogaeva
- Tanz Centre for Research in Neurodegenerative Diseases and Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Peter St George-Hyslop
- Tanz Centre for Research in Neurodegenerative Diseases and Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Cambridge Institute for Medical Research and the Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Giacomina Rossi
- Division of Neurology V and Neuropathology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Fabrizio Tagliavini
- Division of Neurology V and Neuropathology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Giorgio Giaccone
- Division of Neurology V and Neuropathology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - James B Rowe
- Cambridge University Department of Clinical Neurosciences, Cambridge CB2 0SZ, UK; MRC Cognition and Brain Sciences Unit, Cambridge, UK; Behavioural and Clinical Neuroscience Institute, Cambridge, UK
| | - Johannes C M Schlachetzki
- Department of Psychiatry and Psychotherapy, University of Freiburg Medical School, Germany; Department of Molecular Neurology, University Hospital Erlangen, Erlangen, Germany
| | - James Uphill
- MRC Prion Unit, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - John Collinge
- MRC Prion Unit, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Simon Mead
- MRC Prion Unit, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Adrian Danek
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Vivianna M Van Deerlin
- University of Pennsylvania Perelman School of Medicine, Department of Neurology and Penn Frontotemporal Degeneration Center, Philadelphia, PA, USA
| | - Murray Grossman
- University of Pennsylvania Perelman School of Medicine, Department of Neurology and Penn Frontotemporal Degeneration Center, Philadelphia, PA, USA
| | - John Q Trojanowski
- University of Pennsylvania Perelman School of Medicine, Department of Neurology and Penn Frontotemporal Degeneration Center, Philadelphia, PA, USA
| | - Julie van der Zee
- Neurodegenerative Brain Diseases group, Department of Molecular Genetics, VIB, Antwerp, Belgium; Laboratory of Neurogenetics, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - William Deschamps
- Neurodegenerative Brain Diseases group, Department of Molecular Genetics, VIB, Antwerp, Belgium; Laboratory of Neurogenetics, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Tim Van Langenhove
- Neurodegenerative Brain Diseases group, Department of Molecular Genetics, VIB, Antwerp, Belgium; Laboratory of Neurogenetics, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Marc Cruts
- Neurodegenerative Brain Diseases group, Department of Molecular Genetics, VIB, Antwerp, Belgium; Laboratory of Neurogenetics, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Christine Van Broeckhoven
- Neurodegenerative Brain Diseases group, Department of Molecular Genetics, VIB, Antwerp, Belgium; Laboratory of Neurogenetics, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Stefano F Cappa
- Neurorehabilitation Unit, Deptartment Of Clinical Neuroscience, Vita-Salute University and San Raffaele Scientific Institute, Milan, Italy
| | - Isabelle Le Ber
- Inserm, UMR_S975, CRICM, F-75013; UPMC Univ Paris 06, UMR_S975, F-75013; and CNRS UMR 7225, F-75013, Paris, France; AP-HP, Hôpital de la Salpêtrière, Département de Neurologie-Centre de Références des Démences Rares, F-75013, Paris, France
| | - Didier Hannequin
- Service de Neurologie, Inserm U1079, CNR-MAJ, Rouen University Hospital, France
| | | | | | - Alexis Brice
- Inserm, UMR_S975, CRICM, F-75013; UPMC Univ Paris 06, UMR_S975, F-75013; and CNRS UMR 7225, F-75013, Paris, France; AP-HP, Hôpital de la Salpêtrière, Département de Neurologie-Centre de Références des Démences Rares, F-75013, Paris, France
| | - Benedetta Nacmias
- Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA) University of Florence, Florence, Italy
| | - Sandro Sorbi
- Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA) University of Florence, Florence, Italy
| | - Silvia Bagnoli
- Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA) University of Florence, Florence, Italy
| | - Irene Piaceri
- Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA) University of Florence, Florence, Italy
| | - Jørgen E Nielsen
- Danish Dementia Research Centre, Neurogenetics Clinic, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Denmark; Department of Cellular and Molecular Medicine, Section of Neurogenetics, The Panum Institute, University of Copenhagen, Denmark
| | - Lena E Hjermind
- Danish Dementia Research Centre, Neurogenetics Clinic, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Denmark; Department of Cellular and Molecular Medicine, Section of Neurogenetics, The Panum Institute, University of Copenhagen, Denmark
| | - Matthias Riemenschneider
- Saarland University Hospital, Department for Psychiatry and Psychotherapy, Homburg/Saar, Germany; Saarland University, Laboratory for Neurogenetics, Kirrberger, Homburg/Saar, Germany
| | - Manuel Mayhaus
- Saarland University, Laboratory for Neurogenetics, Kirrberger, Homburg/Saar, Germany
| | - Bernd Ibach
- University Regensburg, Department of Psychiatry, Psychotherapy and Psychosomatics, Universitätsstr 84, Regensburg, Germany
| | - Gilles Gasparoni
- Saarland University, Laboratory for Neurogenetics, Kirrberger, Homburg/Saar, Germany
| | - Sabrina Pichler
- Saarland University, Laboratory for Neurogenetics, Kirrberger, Homburg/Saar, Germany
| | - Wei Gu
- Saarland University, Laboratory for Neurogenetics, Kirrberger, Homburg/Saar, Germany; Luxembourg Centre For Systems Biomedicine (LCSB), University of Luxembourg, Luxembourg
| | - Martin N Rossor
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK
| | - Nick C Fox
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK
| | - Jason D Warren
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK
| | - Maria Grazia Spillantini
- University of Cambridge, Department of Clinical Neurosciences, John Van Geest Brain Repair Centre, Cambridge, UK
| | - Huw R Morris
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, School of Medicine, Cardiff, UK
| | - Patrizia Rizzu
- German Center of Neurodegenerative Diseases-Tübingen, Tübingen, Germany
| | - Peter Heutink
- German Center of Neurodegenerative Diseases-Tübingen, Tübingen, Germany
| | - Julie S Snowden
- Institute of Brain, Behaviour and Mental Health, Faculty of Medical and Human Sciences, University of Manchester, Manchester, UK
| | - Sara Rollinson
- Institute of Brain, Behaviour and Mental Health, Faculty of Medical and Human Sciences, University of Manchester, Manchester, UK
| | - Anna Richardson
- Salford Royal Foundation Trust, Faculty of Medical and Human Sciences, University of Manchester, UK
| | - Alexander Gerhard
- Institute of Brain, Behaviour and Mental Health, The University of Manchester, Withington, Manchester, UK
| | - Amalia C Bruni
- Regional Neurogenetic Centre, ASPCZ, Lamezia Terme, Italy
| | | | | | - Chiara Cupidi
- Regional Neurogenetic Centre, ASPCZ, Lamezia Terme, Italy
| | - Livia Bernardi
- Regional Neurogenetic Centre, ASPCZ, Lamezia Terme, Italy
| | - Maria Anfossi
- Regional Neurogenetic Centre, ASPCZ, Lamezia Terme, Italy
| | - Maura Gallo
- Regional Neurogenetic Centre, ASPCZ, Lamezia Terme, Italy
| | | | | | - Rosa Rademakers
- Department of Neuroscience, Mayo Clinic Jacksonville, Jacksonville, FL, USA
| | - Matt Baker
- Department of Neuroscience, Mayo Clinic Jacksonville, Jacksonville, FL, USA
| | - Dennis W Dickson
- Department of Neuroscience, Mayo Clinic Jacksonville, Jacksonville, FL, USA
| | | | | | - David Knopman
- Department of Neurology, Mayo Clinic Rochester, Rochester, MN, USA
| | - Keith A Josephs
- Department of Neurology, Mayo Clinic Rochester, Rochester, MN, USA
| | - Bradley F Boeve
- Department of Neurology, Mayo Clinic Rochester, Rochester, MN, USA
| | - Joseph E Parisi
- Department of Pathology, Mayo Clinic Rochester, Rochester, MN, USA
| | - William W Seeley
- Department of Neurology, University of California, San Francisco, CA, USA
| | - Bruce L Miller
- Department of Neurology, University of California, San Francisco, CA, USA
| | - Anna M Karydas
- Department of Neurology, University of California, San Francisco, CA, USA
| | - Howard Rosen
- Department of Neurology, University of California, San Francisco, CA, USA
| | - John C van Swieten
- Department of Neurology, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Medical Genetics, VU University Medical Centre, Amsterdam, The Netherlands
| | - Elise G P Dopper
- Department of Neurology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Harro Seelaar
- Department of Neurology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Yolande A L Pijnenburg
- Alzheimer Centre and Department of Neurology, VU University Medical Centre, Amsterdam, The Netherlands
| | - Philip Scheltens
- Alzheimer Centre and Department of Neurology, VU University Medical Centre, Amsterdam, The Netherlands
| | - Giancarlo Logroscino
- Department of Basic Medical Sciences, Neurosciences and Sense Organs of the Aldo Moro, University of Bari, Italy
| | - Rosa Capozzo
- Department of Basic Medical Sciences, Neurosciences and Sense Organs of the Aldo Moro, University of Bari, Italy
| | - Valeria Novelli
- Department of Molecular Cardiology, IRCCS Fondazione S Maugeri, Pavia, Italy
| | - Annibale A Puca
- Cardiovascular Research Unit, IRCCS Multimedica, Milan, Italy; Department of Medicine and Surgery, University of Salerno, Baronissi (SA), Italy
| | | | - Alfredo Postiglione
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Graziella Milan
- Geriatric Center Frullone-ASL Napoli 1 Centro, Naples, Italy
| | | | | | - Huei-Hsin Chiang
- Karolinska Institutet, Department NVS, KI-Alzheimer Disease Research Center, Stockholm, Sweden; Department of Geriatric Medicine, Genetics Unit, Karolinska Universtiy Hospital, Stockholm
| | - Caroline Graff
- Karolinska Institutet, Department NVS, KI-Alzheimer Disease Research Center, Stockholm, Sweden; Department of Geriatric Medicine, Genetics Unit, Karolinska Universtiy Hospital, Stockholm
| | | | | | | | | | - Dimitrios Kapogiannis
- Laboratory of Neurosciences, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Luigi Ferrucci
- Clinical Research Branch, National Institute on Aging, Baltimore, MD, USA
| | - Stuart Pickering-Brown
- Institute of Brain, Behaviour and Mental Health, Faculty of Medical and Human Sciences, University of Manchester, Manchester, UK
| | - Andrew B Singleton
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - John Hardy
- Reta Lila Weston Research Laboratories, Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK.
| | - Parastoo Momeni
- Laboratory of Neurogenetics, Department of Internal Medicine, Texas Tech University Health Science Center, Lubbock, Texas, USA
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Buee‐Scherrer V, Papegaey A, Deramecourt V, Lecourtois M, Lebert F, Campion D, Pasquier F, Sergeant N, Buee L. P2–221: Frontotemporal lobar degeneration: Any link between tau and TDP‐43? Alzheimers Dement 2013. [DOI: 10.1016/j.jalz.2013.05.867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | - Luc Buee
- Université Lille 2‐ Inserm UMR837 Lille France
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Lebert F. Expression cognitive des maladies psychiatriques : bipolarité et cognition. Rev Neurol (Paris) 2013. [DOI: 10.1016/j.neurol.2013.01.475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Le Bouc R, Lenfant P, Delbeuck X, Ravasi L, Lebert F, Semah F, Pasquier F. My belief or yours? Differential theory of mind deficits in frontotemporal dementia and Alzheimer's disease. ACTA ACUST UNITED AC 2013; 135:3026-38. [PMID: 23065791 DOI: 10.1093/brain/aws237] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Theory of mind reasoning-the ability to understand someone else's mental states, such as beliefs, intentions and desires-is crucial in social interaction. It has been suggested that a theory of mind deficit may account for some of the abnormalities in interpersonal behaviour that characterize patients affected by behavioural variant frontotemporal dementia. However, there are conflicting reports as to whether understanding someone else's mind is a key difference between behavioural variant frontotemporal dementia and other neurodegenerative conditions such as Alzheimer's disease. Literature data on the relationship between theory of mind abilities and executive functions are also contradictory. These disparities may be due to underestimation of the fractionation within theory of mind components. A recent theoretical framework suggests that taking someone else's mental perspective requires two distinct processes: inferring someone else's belief and inhibiting one's own belief, with involvement of the temporoparietal and right frontal cortices, respectively. Therefore, we performed a neuropsychological and neuroimaging study to investigate the hypothesis whereby distinct cognitive deficits could impair theory of mind reasoning in patients with Alzheimer's disease and patients with behavioural variant frontotemporal dementia. We used a three-option false belief task to assess theory of mind components in 11 patients with behavioural variant frontotemporal dementia, 12 patients with Alzheimer's disease and 20 healthy elderly control subjects. The patients with behavioural variant frontotemporal dementia and those with Alzheimer's disease were matched for age, gender, education and global cognitive impairment. [(18)F]-fluorodeoxyglucose-positron emission tomography imaging was used to investigate neural correlates of theory of mind reasoning deficits. Performance in the three-option false belief task revealed differential impairments in the components of theory of mind reasoning; patients with Alzheimer's disease had a predominant deficit in inferring someone else's belief, whereas patients with behavioural variant frontotemporal dementia were selectively impaired in inhibiting their own mental perspective. Moreover, inhibiting one's own perspective was strongly correlated with inhibition in a Stroop task but not with other subprocesses of executive functions. This finding suggests that self-perspective inhibition may depend on cognitive processes that are not specific to the social domain. Last, the severity of the deficit in inferring someone else's beliefs correlated significantly over all subjects with hypometabolism in the left temporoparietal junction, whereas the severity of the deficit in self-perspective inhibition correlated significantly with hypometabolism in the right lateral prefrontal cortex. In conclusion, our findings provided clinical and imaging evidence to support differential deficits in two components of theory of mind reasoning (subserved by distinct brain regions) in patients with Alzheimer's disease and patients with behavioural variant frontotemporal dementia.
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Affiliation(s)
- Raphaël Le Bouc
- Department of Neurology, Université Lille Nord de France, USLD, CHU Lille, EA 1046, F-59000 Lille, France.
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12
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Deramecourt V, Lebert F, Maurage CA, Fernandez-Gomez FJ, Dujardin S, Colin M, Sergeant N, Buée-Scherrer V, Clot F, Ber IL, Brice A, Pasquier F, Buée L. Clinical, Neuropathological, and Biochemical Characterization of the Novel Tau Mutation P332S. ACTA ACUST UNITED AC 2012; 31:741-9. [DOI: 10.3233/jad-2012-120160] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Vincent Deramecourt
- Univ Lille Nord de France, UDSL, Lille, France
- INSERM U837, JPARC, Lille, France
- CHU Lille, Memory Clinic, Lille, France
- CHU Lille, Department of Pathology, Lille, France
| | - Florence Lebert
- Univ Lille Nord de France, UDSL, Lille, France
- CHU Lille, Memory Clinic, Lille, France
| | - Claude-Alain Maurage
- Univ Lille Nord de France, UDSL, Lille, France
- INSERM U837, JPARC, Lille, France
- CHU Lille, Department of Pathology, Lille, France
| | | | - Simon Dujardin
- Univ Lille Nord de France, UDSL, Lille, France
- INSERM U837, JPARC, Lille, France
| | - Morvane Colin
- Univ Lille Nord de France, UDSL, Lille, France
- INSERM U837, JPARC, Lille, France
| | - Nicolas Sergeant
- Univ Lille Nord de France, UDSL, Lille, France
- INSERM U837, JPARC, Lille, France
| | | | - Fabienne Clot
- Department of Genetics and Cytogenetics, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Isabelle Le Ber
- CR-ICM UMRS9750, Paris, France
- INSERM U975, Paris, France
- Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Alexis Brice
- Department of Genetics and Cytogenetics, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
- CR-ICM UMRS9750, Paris, France
- INSERM U975, Paris, France
- Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Florence Pasquier
- Univ Lille Nord de France, UDSL, Lille, France
- CHU Lille, Memory Clinic, Lille, France
| | - Luc Buée
- Univ Lille Nord de France, UDSL, Lille, France
- INSERM U837, JPARC, Lille, France
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Pasquier F, Deramecourt V, Lebert F. [From Pick's disease to frontotemporal dementia]. Bull Acad Natl Med 2012; 196:431-443. [PMID: 23420961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Frontotemporal dementias (FTD) are defined by a gradual change in social conduct, behavior and language, associated with frontal and anterior temporal lobe degeneration. The clinicalfeatures depend on the location of the degenerative process. In the last 20 years, increasingly specific and sensitive operational criteria have been established. Ongoing neuropathological and genetic studies have highlighted overlaps between FTD, motor neuron disease, and atypical parkinsonian syndromes (supranuclear palsy, corticobasal degeneration). They have also provided a better knowledge of the pathophysiology of FTD, and new specific therapeutic targets. These dementias, which usually occur before the age of 65 years, are now better recognized but are still underdiagnosed and often initially mistaken for psychiatric illnesses. Healthcare professionals managing these patients must therefore be better informed Serotonergic agents provide a symptomatic improvement, but environmental adaptation, prevention of language and swallowing difficulties, and information and support for the family and caregivers remain essential.
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Rascovsky K, Hodges JR, Knopman D, Mendez MF, Kramer JH, Neuhaus J, van Swieten JC, Seelaar H, Dopper EGP, Onyike CU, Hillis AE, Josephs KA, Boeve BF, Kertesz A, Seeley WW, Rankin KP, Johnson JK, Gorno-Tempini ML, Rosen H, Prioleau-Latham CE, Lee A, Kipps CM, Lillo P, Piguet O, Rohrer JD, Rossor MN, Warren JD, Fox NC, Galasko D, Salmon DP, Black SE, Mesulam M, Weintraub S, Dickerson BC, Diehl-Schmid J, Pasquier F, Deramecourt V, Lebert F, Pijnenburg Y, Chow TW, Manes F, Grafman J, Cappa SF, Freedman M, Grossman M, Miller BL. Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia. Brain 2011; 134:2456-77. [PMID: 21810890 PMCID: PMC3170532 DOI: 10.1093/brain/awr179] [Citation(s) in RCA: 3258] [Impact Index Per Article: 250.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Revised: 05/25/2011] [Accepted: 06/13/2011] [Indexed: 12/20/2022] Open
Abstract
Based on the recent literature and collective experience, an international consortium developed revised guidelines for the diagnosis of behavioural variant frontotemporal dementia. The validation process retrospectively reviewed clinical records and compared the sensitivity of proposed and earlier criteria in a multi-site sample of patients with pathologically verified frontotemporal lobar degeneration. According to the revised criteria, 'possible' behavioural variant frontotemporal dementia requires three of six clinically discriminating features (disinhibition, apathy/inertia, loss of sympathy/empathy, perseverative/compulsive behaviours, hyperorality and dysexecutive neuropsychological profile). 'Probable' behavioural variant frontotemporal dementia adds functional disability and characteristic neuroimaging, while behavioural variant frontotemporal dementia 'with definite frontotemporal lobar degeneration' requires histopathological confirmation or a pathogenic mutation. Sixteen brain banks contributed cases meeting histopathological criteria for frontotemporal lobar degeneration and a clinical diagnosis of behavioural variant frontotemporal dementia, Alzheimer's disease, dementia with Lewy bodies or vascular dementia at presentation. Cases with predominant primary progressive aphasia or extra-pyramidal syndromes were excluded. In these autopsy-confirmed cases, an experienced neurologist or psychiatrist ascertained clinical features necessary for making a diagnosis according to previous and proposed criteria at presentation. Of 137 cases where features were available for both proposed and previously established criteria, 118 (86%) met 'possible' criteria, and 104 (76%) met criteria for 'probable' behavioural variant frontotemporal dementia. In contrast, 72 cases (53%) met previously established criteria for the syndrome (P < 0.001 for comparison with 'possible' and 'probable' criteria). Patients who failed to meet revised criteria were significantly older and most had atypical presentations with marked memory impairment. In conclusion, the revised criteria for behavioural variant frontotemporal dementia improve diagnostic accuracy compared with previously established criteria in a sample with known frontotemporal lobar degeneration. Greater sensitivity of the proposed criteria may reflect the optimized diagnostic features, less restrictive exclusion features and a flexible structure that accommodates different initial clinical presentations. Future studies will be needed to establish the reliability and specificity of these revised diagnostic guidelines.
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Affiliation(s)
- Katya Rascovsky
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, 3 West Gates, Philadelphia, PA 19104, USA.
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Rascovsky K, Hodges JR, Knopman D, Mendez MF, Kramer JH, Neuhaus J, van Swieten JC, Seelaar H, Dopper EGP, Onyike CU, Hillis AE, Josephs KA, Boeve BF, Kertesz A, Seeley WW, Rankin KP, Johnson JK, Gorno-Tempini ML, Rosen H, Prioleau-Latham CE, Lee A, Kipps CM, Lillo P, Piguet O, Rohrer JD, Rossor MN, Warren JD, Fox NC, Galasko D, Salmon DP, Black SE, Mesulam M, Weintraub S, Dickerson BC, Diehl-Schmid J, Pasquier F, Deramecourt V, Lebert F, Pijnenburg Y, Chow TW, Manes F, Grafman J, Cappa SF, Freedman M, Grossman M, Miller BL. Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia. Brain 2011. [PMID: 21810890 DOI: 10.1093/brain/awr179.] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Based on the recent literature and collective experience, an international consortium developed revised guidelines for the diagnosis of behavioural variant frontotemporal dementia. The validation process retrospectively reviewed clinical records and compared the sensitivity of proposed and earlier criteria in a multi-site sample of patients with pathologically verified frontotemporal lobar degeneration. According to the revised criteria, 'possible' behavioural variant frontotemporal dementia requires three of six clinically discriminating features (disinhibition, apathy/inertia, loss of sympathy/empathy, perseverative/compulsive behaviours, hyperorality and dysexecutive neuropsychological profile). 'Probable' behavioural variant frontotemporal dementia adds functional disability and characteristic neuroimaging, while behavioural variant frontotemporal dementia 'with definite frontotemporal lobar degeneration' requires histopathological confirmation or a pathogenic mutation. Sixteen brain banks contributed cases meeting histopathological criteria for frontotemporal lobar degeneration and a clinical diagnosis of behavioural variant frontotemporal dementia, Alzheimer's disease, dementia with Lewy bodies or vascular dementia at presentation. Cases with predominant primary progressive aphasia or extra-pyramidal syndromes were excluded. In these autopsy-confirmed cases, an experienced neurologist or psychiatrist ascertained clinical features necessary for making a diagnosis according to previous and proposed criteria at presentation. Of 137 cases where features were available for both proposed and previously established criteria, 118 (86%) met 'possible' criteria, and 104 (76%) met criteria for 'probable' behavioural variant frontotemporal dementia. In contrast, 72 cases (53%) met previously established criteria for the syndrome (P < 0.001 for comparison with 'possible' and 'probable' criteria). Patients who failed to meet revised criteria were significantly older and most had atypical presentations with marked memory impairment. In conclusion, the revised criteria for behavioural variant frontotemporal dementia improve diagnostic accuracy compared with previously established criteria in a sample with known frontotemporal lobar degeneration. Greater sensitivity of the proposed criteria may reflect the optimized diagnostic features, less restrictive exclusion features and a flexible structure that accommodates different initial clinical presentations. Future studies will be needed to establish the reliability and specificity of these revised diagnostic guidelines.
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Affiliation(s)
- Katya Rascovsky
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, 3 West Gates, Philadelphia, PA 19104, USA.
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Rascovsky K, Hodges JR, Knopman D, Mendez MF, Kramer JH, Xie S, Swieten JC, Seelaar H, Dopper EG, Onyike CU, Hillis A, Josephs KA, Boeve BF, Kertesz A, Seeley WW, Rankin K, Johnson JK, Gorno Tempini M, Rosen H, Neuhaus J, Latham C, Lee AS, Kipps CM, Lillo P, Piguet O, Rohrer JD, Rossor M, Warren JD, Fox NC, Galasko D, Salmon DP, Black SE, Mesulam M, Weintraub S, Dickerson BC, Diehl‐Schmid J, Pasquier F, Deramecourt V, Lebert F, Pijnenburg Y, Chow TW, Manes F, Grafman J, Cappa SF, Freedman M, Miller BL, Grossman M. P4‐166: Determinants of survival in autopsy‐confirmed patients with behavioral variant frontotemporal dementia (bvFTD): Second Report of the international bvFTD criteria consortium (FTDC). Alzheimers Dement 2011. [DOI: 10.1016/j.jalz.2011.05.2188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Katya Rascovsky
- University of Pennsylvania School of MedicinePhiladelphiaPennsylvaniaUnited States
| | | | | | | | - Joel H. Kramer
- University of CaliforniaSan FranciscoSan FranciscoCaliforniaUnited States
| | - Sharon Xie
- University of PennsylvaniaPhiladelphiaPennsylvaniaUnited States
| | | | | | | | - Chiadi U. Onyike
- Johns Hopkins University School of MedicineBaltimoreMarylandUnited States
| | - Argye Hillis
- Johns Hopkins University School of MedicineBaltimoreMarylandUnited States
| | | | | | | | - William W. Seeley
- University of CaliforniaSan FranciscoSan FranciscoCaliforniaUnited States
| | - Katherine Rankin
- University of CaliforniaSan FranciscoSan FranciscoCaliforniaUnited States
| | - Julene K. Johnson
- University of CaliforniaSan FranciscoSan FranciscoCaliforniaUnited States
| | | | - Howard Rosen
- University of CaliforniaSan FranciscoSan FranciscoCaliforniaUnited States
| | - John Neuhaus
- University of CaliforniaSan FranciscoSan FranciscoCaliforniaUnited States
| | - Caroline Latham
- University of CaliforniaSan FranciscoSan FranciscoCaliforniaUnited States
| | - Albert S. Lee
- University of CaliforniaSan FranciscoSan FranciscoCaliforniaUnited States
| | | | | | | | | | - Martin Rossor
- UCL Institute of Neurology, Queen SquareLondonUnited Kingdom
| | - Jason D. Warren
- UCL Institute of Neurology, Queen SquareLondonUnited Kingdom
| | - Nick C. Fox
- UCL Institute of Neurology, Queen SquareLondonUnited Kingdom
| | - Douglas Galasko
- University of CaliforniaSan DiegoSan DiegoCaliforniaUnited States
| | - David P. Salmon
- University of CaliforniaSan DiegoSan DiegoCaliforniaUnited States
| | - Sandra E. Black
- Sunnybrook Health Sciences CentreUniversity of TorontoTorontoOntarioCanada
| | - Marsel Mesulam
- Northwestern University Feinberg School of MedicineChicagoIllinoisUnited States
| | - Sandra Weintraub
- Northwestern University Feinberg School of MedicineChicagoIllinoisUnited States
| | - Bradford C. Dickerson
- Massachusetts General Hospital, Harvard Medical SchoolMedfordMassachusettsUnited States
| | | | | | | | | | | | - Tiffany W. Chow
- Rotman Research Institute, University of TorontoTorontoOntarioCanada
| | - Facundo Manes
- Institute of Cognitive NeurologyBuenos AiresArgentina
| | | | | | - Morris Freedman
- Rotman Research Institute, University of TorontoTorontoOntarioCanada
| | - Bruce L. Miller
- University of CaliforniaSan FranciscoSan FranciscoCaliforniaUnited States
| | - Murray Grossman
- University of Pennsylvania School of MedicinePhiladelphiaPennsylvaniaUnited States
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Lebert F, Bieder F, Turcq S. [Caring for "young" Alzheimer's patients in a home for dependent elderly people]. Soins Gerontol 2010:28-30. [PMID: 21137490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Alzheimer's disease can affect people under the age of 60, considered as "young" patients. In France, the disease affects 8 000 such people today. Caring for them at home is sometimes impossible and the 2008-2012 Alzheimer plan comprises a measure to reflect on requirements with regard to medico-social establishments. For the last ten years, a residential home for dependent elderly people in the north of France has regularly taken in "young" residents with Alzheimer's disease and reports, via a study, on their characteristics and their needs.
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Affiliation(s)
- Florence Lebert
- Centre National de Référence des Malades Alzheimer Jeunes, Université Lille Nord de France.
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Deramecourt V, Lebert F, Debachy B, Mackowiak-Cordoliani MA, Bombois S, Kerdraon O, Buee L, Maurage CA, Pasquier F. Prediction of pathology in primary progressive language and speech disorders. Neurology 2009; 74:42-9. [DOI: 10.1212/wnl.0b013e3181c7198e] [Citation(s) in RCA: 150] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Lebert F, Pasquier F. O2-6 Utilisation des antipsychotiques chez “les malades jeunes”. Rev Neurol (Paris) 2009. [DOI: 10.1016/s0035-3787(09)72595-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Deramecourt V, Lebert F, Buee L, Maurage CA, Pasquier F. O1‐02‐02: Prediction of neuropathology in primary progressive language and speech disorders. Alzheimers Dement 2009. [DOI: 10.1016/j.jalz.2009.05.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Vincent Deramecourt
- Memory ClinicUniversity HospitalLilleFrance
- EA2691Lille II UniversityLilleFrance
| | - Florence Lebert
- Memory ClinicUniversity HospitalLilleFrance
- EA2691Lille II UniversityLilleFrance
| | | | - Claude Alain Maurage
- INSERM U837JPARCLilleFrance
- Neuropathology DepartmentUniversity HospitalLilleFrance
| | - Florence Pasquier
- Memory ClinicUniversity HospitalLilleFrance
- EA2691Lille II UniversityLilleFrance
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Lebert F. [Is frontotemporal dementia a disease of identity?]. Psychol Neuropsychiatr Vieil 2009; 7:79-83. [PMID: 19473950 DOI: 10.1684/pnv.2009.0167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Patients with frontotemporal dementia (FTD) have major behavioral troubles and a loss of insight. These factors contribute to reduce self-awareness and recognition of identify of others and by others. Autobiographical amnesia, loss of insight and executive dysfunctions are the major reasons of vulnerable "self" in FTD. Mind representation deficits, decrease of perception of emotions and semantic amnesia contribute to reduced recognition of the relative's identity. Alterations of body expressions, social disinhibition, changes in social and religious values decrease the recognition of patient's identity by the relatives. Different psychological components of identity are modified by the FTD such as feeling of unity, of consistency, of temporality and of affiliation. The fact that brain lesions of FTD are focalized can contribute to understand the biological knowledge of "identity". To know the neurological substrate of alterations of identity, this can help to improve the empathy of the suffering caregivers for the patient.
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Lebert F, Pasquier F. [Behavioral problems in Alzheimer disease: current and future treatments]. Rev Neurol (Paris) 2009; 165 Spec No 2:F104-F108. [PMID: 19593881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- F Lebert
- Centre mémoire de ressources et de recherche, EA 2691, Centre hospitalier regional universitaire, Lille, France.
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Bruandet A, Richard F, Bombois S, Maurage CA, Deramecourt V, Lebert F, Amouyel P, Pasquier F. Alzheimer disease with cerebrovascular disease and vascular dementia: clinical features and course compared with Alzheimer disease. J Neurol Neurosurg Psychiatry 2009; 80:133-9. [PMID: 18977819 DOI: 10.1136/jnnp.2007.137851] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Vascular dementia (VaD) and Alzheimer disease with cerebrovascular disease (AD+CVD) are the leading causes of dementia after Alzheimer disease alone (AD). Little is known about the progression of either VaD or AD+CVD. The aim of this study was to compare demographic features, cognitive decline and survival of patients with VaD, AD+CVD and AD alone attending a memory clinic. METHODS This study included 970 patients who were followed at the Lille-Bailleul memory clinic, France. Cognitive functions were measured with the Mini Mental State Examination (MMSE) and the Dementia Rating Scale (DRS). Survival rate was analysed with a left-truncated Cox model. Analyses were adjusted for age, sex, education, hypertension, diabetes and baseline MMSE and DRS. RESULTS Of 970 patients, 141 had VaD, 663 AD alone and 166 AD+CVD. The latter were significantly older than AD or VaD patients at onset (71 (SD 7) vs 69 (9) and 68 (9) years, p = 0.01) and at first visit (75 (6) vs 73 (8) and 72 (8) years, p = 0.0002). Baseline MMSE and DRS evaluations were highest for VaD compared with AD alone or AD+CVD patients (p<0.006). Cognitive decline during follow-up was slowest for VaD, intermediate for AD+CVD and fastest for AD alone (p = 0.03). After adjustment, compared with AD patients, mortality risk was similar for those with VaD (relative mortality risk (RR) = 0.7 (0.5 to 1.1)) and tended to be lower for AD+CVD (RR = 0.7 (0.5 to 1.0)). The shorter the delay between first symptoms and first visit, the longer patients survived. CONCLUSION This clinical cohort study shows that patients with VaD, AD+CVD and AD present different characteristics at baseline and during follow-up, and underlines the need to distinguish between them.
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Lebert F, Lys H, Haëm E, Pasquier F. Syndrome démentiel dans les suites d’une bipolarité. Encephale 2008; 34:606-10. [DOI: 10.1016/j.encep.2007.12.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2007] [Accepted: 12/13/2007] [Indexed: 10/22/2022]
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Deramecourt V, Bombois S, Mackowiak MA, Delacourte A, Buee L, Maurage CA, Lebert F, Pasquier F. P3-008: Associated cerebral lesions in Alzheimer's disease generate clinical diagnosis difficulties: An autopsy study. Alzheimers Dement 2008. [DOI: 10.1016/j.jalz.2008.05.1571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | | | | | | | | | - Claude-Alain Maurage
- Department of neuropathology; Lille University Hospital; Lille France
- INSERM; U 837 Lille France
| | - Florence Lebert
- Memory Clinic, EA, 2691, Lille University Hospital; Lille France
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Pasquier F, Hamedani A, Lebert F. O3‐06–02: Long‐lasting behavioral variant of frontotemporal dementia is frequently associated with bipolar disorders. Alzheimers Dement 2008. [DOI: 10.1016/j.jalz.2008.05.451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Deramecourt V, Lebert F, Bombois S, Mackowiak M, Delacourte A, Pasquier F, Maurage C. V - 3 Dégénérescences lobaires frontotemporales avec inclusions ubiquitine positives : données cliniques, neuropathologiques et biochimiques de 14 cas. Rev Neurol (Paris) 2007. [DOI: 10.1016/s0035-3787(07)90762-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Richard F, Bruandet A, Sorel V, Dusart A, Chartier-Harlin M, Amouyel P, Lebert F, Pasquier F, Lambert J. P10-3 - Gène de l’apolipoprotéine E et survie dans la maladie d’Alzheimer. Rev Epidemiol Sante Publique 2006. [DOI: 10.1016/s0398-7620(06)76939-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Richard F, Bruandet A, Sorel V, Dusart A, Chartier-Harlin MC, Amouyel P, Lebert F, Pasquier F, Lambert JC. P1–311: APOE locus and survival in a French cohort of demented cases. Alzheimers Dement 2006. [DOI: 10.1016/j.jalz.2006.05.689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Deramecourt V, Bombois S, Maurage CA, Lebert F, Delacourte A, Pasquier F. P4–113: Clinicopathologic and biochemical overlap of frontotemporal degeneration, corticobasal degeneration and progressive supranuclear palsy: The Lille–Bailleul French cohort. Alzheimers Dement 2006. [DOI: 10.1016/j.jalz.2006.05.1852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Deramecourt V, Bombois S, Maurage CA, Ghestem A, Drobecq H, Vanmechelen E, Lebert F, Pasquier F, Delacourte A. Biochemical Staging of Synucleinopathy and Amyloid Deposition in Dementia With Lewy Bodies. J Neuropathol Exp Neurol 2006; 65:278-88. [PMID: 16651889 DOI: 10.1097/01.jnen.0000205145.54457.ea] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The primary feature of dementia with Lewy bodies (DLB) is the aggregation of alpha-synuclein into characteristic lesions: Lewy bodies (LBs) and Lewy neurites. However, in most of DLB cases, LBs are associated with neurofibrillary tangles and amyloid plaques (both Alzheimer disease [AD]-related lesions). We wanted to determine if this overlap of lesions is statistical, as a result of the late onset of both diseases, or results from a specific physiopathological synergy between synucleinopathy and either tauopathy or amyloid pathology. All patients with DLB from our prospective and multidisciplinary study were analyzed. These cases were compared with cases with pure AD and patients with Parkinson disease and controls. All cases were analyzed thoroughly at the neuropathologic and biochemical levels with a biochemical staging of aggregated alpha-synuclein, tau, and Abeta species. All sporadic cases of DLB were associated with abundant deposits of Abeta x-42 that were similar in quality and quantity to those of AD. Amyloid precursor protein (APP) dysfunction is a risk factor for AD as demonstrated by pathogenic mutations and Abeta accumulation. The constant and abundant Abeta x-42 deposition in sporadic DLB suggests that synucleinopathy is also promoted by APP dysfunction. Therefore, we conclude that APP is a therapeutic target for both AD and DLB.
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Lebert F, Le Rhun E. Prise en charge thérapeutique de la démence à corps de Lewy. Rev Neurol (Paris) 2006; 162:131-6. [PMID: 16446631 DOI: 10.1016/s0035-3787(06)74993-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Dementia with Lewy bodies (DLB) is known for its partial resistance and hypersensitivity to some treatments, but DLB is treatable with cholinesterase inhibitors, sometimes better than in Alzheimer's disease. Cholinesterase inhibitors have a symptomatic effect on cognition and behavior. Nevertheless, new antipsychotics are sometimes also useful to manage psychotic symptoms. Although DLB patients respond less well to levodopa than patients with Parkinson's disease, 75 percent of DLB patients improve with levodopa, which is the best-tolerated dopaminergic agent. Nonpharmacological strategies include speech therapy, physiotherapy, psychotherapy, and educational support groups for care givers.
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Affiliation(s)
- F Lebert
- Centre de la Mémoire, EA 2691, Clinique Neurologique, Hôpital Roger Salengro, Centre Hospitalier Universitaire, Lille.
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Paulin M, Seillier D, Husson J, Al khedr A, Memin A, Lebert F, Bombois S, Mackowiak-Cordoliani M, Pasquier F. P2-20 Comparaison de la tolérance et de l’efficacité à 2 ans des inhibiteurs de l’acétylcholinestérase (IAChE) chez des patients atteints de maladie d’alzheimer. Rev Neurol (Paris) 2005. [DOI: 10.1016/s0035-3787(05)85348-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Laurier-Grymonprez L, Pasquier F, Lebert F. P4-19 Expérience d’un programme d’intervention en groupe auprès de patients atteints par une maladie à corps de Lewy et de leur aidant principal. Rev Neurol (Paris) 2005. [DOI: 10.1016/s0035-3787(05)85418-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Haëm E, Laurier-Grymonprez L, Pasquier F, Lebert F. P3-18 Démence suite à un trouble bipolaire : caractérisation neuropsychologique. Rev Neurol (Paris) 2005. [DOI: 10.1016/s0035-3787(05)85383-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lebert F. C3-2 Influence comportementale de la composante vasculaire dans une démence. Rev Neurol (Paris) 2005. [DOI: 10.1016/s0035-3787(05)85273-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Vellas B, Gauthier S, Allain H, Andrieu S, Aquino JP, Berrut G, Berthel M, Blanchard F, Camus V, Dartigues JF, Dubois B, Forette F, Franco A, Gonthier R, Grand A, Hervy MP, Jeandel C, Joel ME, Jouanny P, Lebert F, Michot P, Montastruc JL, Nourhashemi F, Ousset PJ, Pariente J, Rigaud AS, Robert P, Ruault G, Strubel D, Touchon J, Verny M, Vetel JM. [Consensus statement on severe dementia]. Presse Med 2005; 34:1545-55. [PMID: 16301969 DOI: 10.1016/s0755-4982(05)84221-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Under the auspices of the French Society of Gerontology and Geriatrics, a multidisciplinary group of experts, including geriatricians, neurologists, epidemiologists, psychiatrists, pharmacologists, and public health specialists developed consensus recommendations about care for patients with severe dementia. They defined 21 recommendations for general practitioners, long-term care physicians, and specialists, based on the knowledge currently available (2005). The aim of care at all stages is to mitigate the quality-of-life of patient, caregiver, and family insofar as possible, combining care and future planning until the end of life. Management, to take into account problems including nutritional status, behavior disorders, and ability (or inability) to perform activities of daily living, must be global, multidisciplinary, and coordinated and must optimize use of local medical and social resources. The group also stressed the importance of clinical research to improve knowledge of disease course and assess management strategies and recommended specific area for research.
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Affiliation(s)
- B Vellas
- CHU Casselardit, secteur A gériatrie, Toulouse.
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Bombois S, Lebert F, Vellas B, Pasquier F. [Treatment of Alzheimer's disease]. Rev Prat 2005; 55:1913-9. [PMID: 16396232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Alzheimer's disease (AD) is a neurodegenerative disorder with a decline in memory and cognitive abilities. During the past 20 years, research on AD has increased the knowledge of the physiopathological mechanisms leading to the disease. The major hallmarks of AD are amyloid plaques and neurofibrillary tangles, associated with a prevalent and early cholinergic deficit and an excitotoxicity with inflammation. These pathological mechanisms represent current and future therapeutic targets. cholinesterase inhibitors were the first therapeutic class that has consistently shown a clinical efficacy and safety in patients with mild to moderate ad. more recently glutamate receptor antagonists have been shown effective in the management of patients with moderate to severe AD. These two therapeutic classes could improve cognitive functions, slow the progression of the cognitive decline, prevent some behavioural changes and delay institutionalisation. However, AD represents a problem of public health and preventive and curative strategies have to be proposed.
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Affiliation(s)
- Stéphanie Bombois
- Centre mémoire de ressource et de recherche, EA 2691, CHRU de Lille, 59037 Lille.
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Vellas B, Gauthier S, Allain H, Andrieu S, Aquino JP, Berrut G, Berthel M, Blanchard F, Camus V, Dartigues JF, Dubois B, Forette F, Franco A, Gonthier R, Grand A, Hervy MP, Jeandel C, Joel ME, Jouanny P, Lebert F, Michot P, Montastruc JL, Nourhashemi F, Ousset PJ, Pariente J, Rigaud AS, Robert P, Ruault G, Strubel D, Touchon J, Verny M, Vetel JM. Consensus sur la démence de type Alzheimer au stade sévère. Rev Neurol (Paris) 2005; 161:868-77. [PMID: 16244574 DOI: 10.1016/s0035-3787(05)85152-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Under the auspices of the French Society of Gerontology and Geriatrics, a multidisciplinary team including geriatritians, neurologists, epidemiologists, psychiatrists, pharmacologists and public health specialists developed a consensus on care for patients with severe dementia. They defined 21 recommendations for general practitioners, long-term care physicians and specialists based on knowledge available in 2005. At all stages of the disease, the objective of care is to improve as much as possible quality-of-life for the patient and his/her family, including a life project until the end of life. It is always possible to do something for these patients and their family: nutritional status, behavior disorders, and incapacities to deal with basic activities of daily life have to be taken in consideration. Resource allocation and proximity care have to be targeted. Research areas necessary to improve the care of patients with severe dementia has been selected.
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Vellas B, Gauthier S, Allain H, Andrieu S, Aquino JP, Berrut G, Berthel M, Blanchard F, Camus V, Dartigues JF, Dubois B, Forette F, Franco A, Gonthier R, Grand A, Hervy MP, Jeandel C, Joel ME, Jouanny P, Lebert F, Michot P, Montastruc JL, Nourhashemi F, Ousset PJ, Pariente J, Rigaud AS, Robert P, Ruault G, Strubel D, Touchon J, Verny M, Vetel JM. Consensus statement on dementia of Alzheimer type in the severe stage. J Nutr Health Aging 2005; 9:330-8. [PMID: 16222399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
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Abstract
Behavioural troubles due to frontotemporal dementia (FTD) are difficult to treat. The serotonergic system is associated with frontal lobes, the degeneration of which contributes to FTD. Trazodone increases the extracellular 5-HT levels in the frontal cortex. In a randomised, double-blind, placebo-controlled cross-over study, we investigated the effect of trazodone. There was a significant decrease in the Neuropsychiatry Inventory (NPI) total score with trazodone (p = 0.028) in the 26 evaluable patients. A decrease of more than 50% in the NPI score was observed in 10 patients with trazodone. This improvement was mainly based on the improvement of 4 items of the scale (irritability, agitation, depressive symptoms and eating disorders). The Mini-Mental State Examination was not modified and trazodone was well tolerated. Results of this first placebo-controlled trial suggest that trazodone is an effective treatment for the behavioural symptoms of FTD.
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Abstract
INTRODUCTION Frontotemporal dementia (FTD) is a more common cause of dementia than previously recognised. Few data are available regarding the natural course of FTD in terms of survival, nursing home admission and causes of death. METHODS An observational study of all consecutive patients referred to the memory centre of Lille, France, between 1995 and 1999, and examined at least twice in this centre, with a diagnosis of FTD (frontal or behavioural variant) or of Alzheimer's disease (AD) was performed. Kaplan-Meyer analysis allowing for delayed entry was used to compare the survival functions in FTD and AD. RESULTS 552 patients were included, of whom 49 (8.9%) were lost to follow-up at 3 years. FTD patients were younger (mean age at onset 59 years), had more often a family history of psychiatric disorders (20%), had a longer delay between first symptoms and first visit (5.9 years) and a higher Mini-Mental State Examination (MMSE) score at first visit (24.5) than patients with AD (19.9). The mean annual MMSE score decline was 0.9 point in FTD vs. 2.0 points in AD (p < 0.0004). Fewer patients with FTD than with AD entered an institution (RR: 0.20, 95% CI 0.05-0.81). After adjustment for sex, age at first visit, level of education and MMSE score at first visit, survival rates in FTD and AD did not differ significantly. Patients with FTD often had a sudden death, the cause of which could not be found. The earlier the first visit after onset, the longer the survival rate, whatever the diagnosis (RR: 0.76, 95% CI 0.67-0.86, p < 0.0001 per year of earlier first visit). CONCLUSION This large study showed that the mean duration of FTD was 2 years longer than that of AD, but the risk of death after adjustment for age and sex was similar in FTD and in AD. Sudden and unexplained causes of death were frequent and need further study. Early management increases the life span of demented patients.
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Affiliation(s)
- Florence Pasquier
- Memory Clinic, University Hospital, EA 2691, and INSERM U 508, Lille, France.
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Lebert F. [Vascular depression, limits of the concept]. Psychol Neuropsychiatr Vieil 2004; 2:173-9. [PMID: 15689331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
The concept of vascular depression has recently been reassessed and more clearly delineated. The diagnostic criteria for vascular depression require a major depression associated with evidence of confluent or diffuse vascular lesions in the subcortical regions on MRI. The clinical symptoms are not specific, but they are often associated with mild cognitive decline. Ischemia is probably the main factor for vascular depression, but the relationship between ischemic lesions and clinical symptoms remains not well explained. The apolipoproteine E genotype is not a risk factor for vascular depression, but it is associated with more severe hyperintensities on MRI. A pharmacological resistance has been described in vascular depression, but, in recent studies, clinical improvement has been observed with antidepressants in more than 80% of cases. A neuropsychological follow-up is recommended, because dementia may appear with 25% of patients.
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Abstract
OBJECTIVE To determine frequency, determinants, and time course of poststroke depressive symptoms (DS) and their relationship with dementia. METHODS Two hundred two consecutive stroke patients were prospectively evaluated for DS, followed up over a 3-year period. Patients with Montgomery and Asberg Depression Rating Scale (MADRS) scores of >/==" BORDER="0">7 were considered as having DS. The severity of the neurologic deficit, functional outcome, and dementia were quantified with the Orgogozo Scale, modified Rankin Scale, Informant Questionnaire on Cognitive Decline in the Elderly, and an extensive battery of neuropsychological tests. RESULTS DS were present in 43% of survivors after 6 months, 36% after 12 months, 24% after 24 months, and 18% after 36 months. The severity of the neurologic deficit at admission was the only independent predictor of DS at month 6. DS at month 6 were more frequent in patients with previous depression, dementia, and right superficial lesions. Younger age and right superficial lesions were the two variables independently associated with the presence of DS at month 36. The time course of the various DS differed, sadness remaining frequent 3 years after stroke (50%), whereas slowness, psychic slowness, lack of energy, and concentration difficulties remained frequent at month 36 in patients with dementia. CONCLUSION DS are frequent after stroke. Their time course varies and depends on the cognitive status; this variation contributes to differences among previous studies on poststroke depression.
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Affiliation(s)
- A Verdelho
- Stroke Department and Memory Clinic, Department of Neurology, University of Lille, Roger Salengro Hospital, Lille, France
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Lebert F. [Treatment of frontotemporal dementia]. Psychol Neuropsychiatr Vieil 2004; 2:35-42. [PMID: 15683967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Frontotemporal dementia (FTD) is the most neglected dementia by pharmacological research. Nevertheless, FTD can be now diagnosed with a good accuracy. Serotonin deficit is found in FTD and most of FTD are tauopathies. Pharmacological agents such as trazodone have showed a positive effect on behavioral symptoms, but the cognitive symptoms can not be significantly improved and parameters to follow a long-term trial in FTD remain to be identified. The recognition of the differences between FTD and Alzheimer's disease allows to determine a specific management of FTD patients and their caregivers.
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Maurage CA, Sergeant N, Schraen-Maschke S, Lebert F, Ruchoux MM, Sablonnière B, Pasquier F, Delacourte A. Diffuse form of argyrophilic grain disease: a new variant of four-repeat tauopathy different from limbic argyrophilic grain disease. Acta Neuropathol 2003; 106:575-83. [PMID: 14517683 DOI: 10.1007/s00401-003-0762-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2003] [Revised: 07/22/2003] [Accepted: 07/22/2003] [Indexed: 11/25/2022]
Abstract
Argyrophilic grain disease (AGD) is characterized by the occurrence of argyrophilic grains and coiled bodies in brain tissue, mainly in limbic areas located in the temporal lobe. Recent biochemical data have shown that inclusions in AGD consist of aggregates of pathological microtubule-associated tau protein isoforms of 64/69 kDa. We report here a study on two AGD patients, belonging to a series of demented patients affected by several tauopathies, prospectively followed until death. In both patients, clinical, neuropathological and biochemical investigations clearly demonstrated AGD. Diffuse tau pathology was shown by Gallyas' silver stain, tau immunohistochemistry and tau protein variant biochemical analysis, not only in temporal lobes but also in all cortical and subcortical areas that were assessed. Primary motor, primary sensory, and associative brain cortices were involved, as well as brain stem, but not cerebellum. We suggest that "diffuse" AGD might be a subgroup of AGD, the specific profile of which is different from that of "limbic" AGD.
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Affiliation(s)
- Claude-Alain Maurage
- INSERM U422, Faculté de Médecine, Université de Lille 2, 1 place de Verdun, 59045 Cedex, Lille, France
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Lebert F, Pasquier F. [Treatment of psychiatric and behavioural symptoms in Alzheimer's disease]. Rev Neurol (Paris) 2003; 159:825-30. [PMID: 13679730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
Affiliation(s)
- F Lebert
- Centre de la Mémoire, Centre Médical des Monts de Flandre, Bailleul.
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