Frontotemporal lobar degeneration

EBM Guidelines
Sep 8, 2021 • Completely updated
Eino Solje and Johanna Krüger

Table of contents

Extract

  • Frontotemporal lobar degeneration (FTLD) is a group of progressive memory disorders with atrophy in the frontotemporal lobes of the brain.
    • Frontotemporal dementia
    • Primary progressive aphasia
      • Progressive nonfluent aphasia
      • Semantic dementia
      • Logopenic progressive aphasia
    • FTLD plus syndromes
    • Progressive supranuclear palsy (PSP)
    • Corticobasal degeneration
  • About 30% of all progressive memory disorders belong to the FTLD group.
  • In about 50% of patients, excluding those with FTLD plus syndromes, there is a positive family history.
  • The most common genetic aetiology associated with frontotemporal lobar degeneration is a non-coding repeat expansion of the C9orf72 (chromosome 9 open-reading frame 72) gene.
    • Study of the C9orf72 mutation may be beneficial for the diagnosis of these diseases.
    • FTLD patients of non-Finnish origin commonly have mutations in GRN and MAPT genes, as well.
    • Genetic testing is done in specialized care.
  • As frontotemporal lobar degeneration may have several underlying neuropathological subtypes, there are no specific biomarkers available for the disease.
  • CSF biomarker (tau, p-tau and amyloid β) tests used for the diagnosis of Alzheimer’s disease do not reliably distinguish between frontotemporal lobar degeneration and Alzheimer’s disease.
  • Normal findings in conventional cognitive screening tests (CERAD and MMSE) do not exclude diseases of the FTLD group.
  • The disease should primarily be diagnosed and treatment started by a neurologist, geriatrician or other physician with expertise in memory disorders.

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Dementia, F03, Frontotemporal dementia, Frontotemporal lobar degeneration, G31.1, Geriatrics, Memory Disorders, Neurology, Progressive nonfluent aphasia, Psychiatry, Semantic dementia