Active lifestyles moderate clinical outcomes in autosomal dominant frontotemporal degeneration

INTRODUCTION

Leisure activities impact brain aging and may be prevention targets. We characterized how physical and cognitive activities relate to brain health for the first time in autosomal dominant frontotemporal lobar degeneration (FTLD).

METHODS

A total of 105 mutation carriers (C9orf72/MAPT/GRN) and 69 non-carriers reported current physical and cognitive activities at baseline, and completed longitudinal neurobehavioral assessments and brain magnetic resonance imaging (MRI) scans.

RESULTS

Greater physical and cognitive activities were each associated with an estimated >55% slower clinical decline per year among dominant gene carriers. There was also an interaction between leisure activities and frontotemporal atrophy on cognition in mutation carriers. High-activity carriers with frontotemporal atrophy (-1 standard deviation/year) demonstrated >two-fold better cognitive performances per year compared to their less active peers with comparable atrophy rates.

DISCUSSION

Active lifestyles were associated with less functional decline and moderated brain-to-behavior relationships longitudinally. More active carriers "outperformed" brain volume, commensurate with a cognitive reserve hypothesis. Lifestyle may confer clinical resilience, even in autosomal dominant FTLD.

Comparison of sporadic and familial behavioral variant frontotemporal dementia (FTD) in a North American cohort

INTRODUCTION

Behavioral variant frontotemporal dementia (bvFTD) may present sporadically or due to an autosomal dominant mutation. Characterization of both forms will improve understanding of the generalizability of assessments and treatments.

METHODS

A total of 135 sporadic (s-bvFTD; mean age 63.3 years; 34% female) and 99 familial (f-bvFTD; mean age 59.9; 48% female) bvFTD participants were identified. f-bvFTD cases included 43 with known or presumed chromosome 9 open reading frame 72 (C9orf72) gene expansions, 28 with known or presumed microtubule-associated protein tau (MAPT) mutations, 14 with known progranulin (GRN) mutations, and 14 with a strong family history of FTD but no identified mutation.

RESULTS

Participants with f-bvFTD were younger and had earlier age at onset. s-bvFTD had higher total Neuropsychiatric Inventory Questionnaire (NPI-Q) scores due to more frequent endorsement of depression and irritability.

DISCUSSION

f-bvFTD and s-bvFTD cases are clinically similar, suggesting the generalizability of novel biomarkers, therapies, and clinical tools developed in either form to the other.

Comparison of training activities and game demands in the Australian Football League

his paper serves as a companion to our recent study of the movement patterns and game activities of players (from five different positions) during matches in the 2000 Australian Football League season. Using lapsed-time video analysis, the same individual players (n= 11) as filmed in matches were also monitored during 21 in-season, main training sessions conducted by their clubs in order to assess the degree to which training activities matched game demands. In general, the training sessions did not involve physical pressure; therefore there were very few contested marks and ground balls or tackles, shepherds and spoils, thereby not matching these game demands. Players typically had more possessions (kicks and handballs) at training than in games. They also spent a greater percentage of total time standing and less time walking at training than in games. Fast-running and sprinting efforts at training were almost all for durations of <6 secs, which matched game demands, as did changes of direction when sprinting, which were almost all in a 0-90 degrees arc. However, across all players filmed, high intensity (fast-running and sprinting) movements were not performed as frequently at training (one every 76 secs) as in games (one every 51 secs). Therefore, while some game demands were adequately replicated at training, others were not closely simulated, suggesting that, after careful interpretation of these results, some improvements in training practices could be made.

Player movement patterns and game activities in the Australian Football League

In the Australian Football League (AFL), specific game movements and activities have not been studied since the 1970s and 1980s and the game is now much faster than it was 20-30 years ago. Using lapsed-time video analysis, AFL players from five different positions (full forward/full back, centre half forward/centre half back, small forward/small back, mid fielders and ruckmen) had their movement patterns (stand, walk, jog, fast-run, sprint, change of direction) and game activities (possessions, ruck duels, ground ball contests, shepherds, spoils, bumps and tackles) recorded in two games each in the 2000 season. A descriptive analysis of the results was undertaken. The main findings were: full forward/full back were most different from the other positions, as they were seen to stand more and jog and fast-run less: ruckmen and midfielders were involved in more game activities than the other positions; for all positions, there were more than 150 high intensity movements (fast-run plus sprint) in the game, but these accounted for only 4-6% of total movement time: virtually all of the high intensity movements lasted for <6 secs; more than half of all sprints involved at least one change of direction, mostly within the 0-90 degrees arc (left or right) and all ground ball contests took <6 secs, with midfielders having 2-3 times as many as the other positions. Improvements in specific pre-season and in-season training practices for different positions should be possible after careful interpretation of these findings.

Video analysis of selected game activities in Australian Rules Football

The frequency and outcome of common game activities during Australian football matches have not previously been reported. The aim of this investigation was to determine the frequency and outcome of marking opportunities (MO), ruck contests (RC) and kick-ins (KI). for the purpose of potentially refining current training methods to better replicate common game occurrences. Video footage of all 24 Australian Football League (AFL) matches in which the West Coast Eagles (WCE) participated during the 1997 premiership season was viewed. Notational analysis was used to record information for both the WCE and the opposition during MO, RC and KI. There was an average of 259 MO per game, of which 42.5% were unopposed by either team (1/0 or 0/1) and 45.0% involved one player from each team (1/1). The average success rate of unopposed marks (1/0 and 0/1) was 88.3%, opposed (1/1) 29.3% and, for all MO's combined, 53.5%. There was an average of 99 RC per game, of which 48 were bounce-downs (28 centre bounces) and 51 boundary throw-ins. The clearance rates from RC for WCE and the opposition were not associated with winning the match or each quarter (p> 0.05, R = 0.000), nor did the clearance rate correlate with other measures of game success (scoring shots, team quarter score, the difference in score between teams or the lead change each quarter). There was an average of 21 KI per game. For both teams combined, long kicks (over 50 metres) were the most preferred form of KI (49%) compared to medium (between 25 and 50 metres) (30%) and short (under 25 metres) (21%). Long kicks were the most ineffective at directly retaining possession (29.0%) whilst short kicks were the most effective (93.4%). Some practical (training) implications, based on these results, are discussed.