Brainstem atrophy is linked to extrapyramidal symptoms in frontotemporal dementia
Date:
April 7, 2022
Source:
University of Eastern Finland
Summary:
Frontotemporal dementia patients with extrapyramidal symptoms
have brainstem atrophy and reduced metabolism in certain areas
of the brain significantly more often than patients without
extrapyramidal symptoms, a new study shows. This observation can
facilitate differential diagnostics in frontotemporal dementia.
FULL STORY ========================================================================== Frontotemporal dementia patients with extrapyramidal symptoms have
brainstem atrophy and reduced metabolism in certain areas of the brain significantly more often than patients without extrapyramidal symptoms,
a new study from the University of Eastern Finland shows. This observation
can facilitate differential diagnostics in frontotemporal dementia. The findings were published in Journal of Neurology.
========================================================================== Frontotemporal dementia, FTD, is an umbrella term for degenerative brain diseases that affect behaviour and cognition. Sometimes, FTD comes with extrapyramidal symptoms, such as those in Parkinson's disease, and this
makes the diagnosis of FTD challenging. However, the new study now shows
that accurate imaging and analysis of the brain may make it possible
to distinguish between FTD and other diseases that cause extrapyramidal symptoms.
Extrapyramidal symptoms refer to involuntary movements, typically
tremor, slowness, stiffness, loss of facial expressions and automatic movements, such as arm swing when walking. They are often associated
with extrapyramidal disorders such as Parkinson's disease and atypical parkinsonism. Examples of atypical parkinsonism include progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD). They
share disease mechanisms with frontotemporal dementia, which is
why they are nowadays considered to be part of the same spectrum of
diseases. Frontotemporal dementia is traditionally divided into two main categories: the more common variant with behavioural changes as an early symptom, and the rarer primary progressive aphasia (PPA) with problems
related to speech as an early symptom.
Neurodegeneration associated with progressive memory disorders is
typically imaged in two ways: magnetic resonance imaging of the brain
provides accurate information on brain structures and volumes of the
different parts of the brain, whereas positron emission tomography,
or a PET scan, provides information on metabolism in different areas of
the brain. Degeneration of the brain tissue is often preceded by slow
or missing metabolism.
The researchers analysed Kuopio University Hospital's medical records on a total of 139 patients with frontotemporal dementia, PSP or CBD, focusing
in particular on their diagnosis and the presence of extrapyramidal
symptoms. The patients' MRI and PET images were analysed using automated analysis software.
The researchers found that patients with extrapyramidal symptoms also had atrophy of the basal ganglia in the midbrain, and of the brainstem. When looking at patients with frontotemporal dementia alone, it was found that patients with extrapyramidal symptoms had brainstem atrophy considerably
more often than patients without extrapyramidal symptoms. In addition,
PET image analyses showed reduced metabolism in the superior cerebellar peduncle and the frontal lobes in patients with extrapyramidal symptoms.
The study showed, for the first time, that significant structural and
metabolic differences can be detected in the brain of frontotemporal
dementia patients with extrapyramidal symptoms, compared to patients
without these symptoms.
"If our findings are confirmed in other cohorts, they can be used in
early diagnostics to distinguish between frontotemporal dementia and Parkinson's disease, for example. These findings will also provide us
with a better understanding of the mechanisms of these diseases," says
Doctoral Researcher Sami Heikkinen, the lead author of the article.
"Although the treatment of these diseases is symptomatic at the moment, an early and accurate diagnosis is an important step towards the development
of disease modifying treatments." The study was conducted in the research group on Frontotemporal Lobar Degeneration and Early Onset Dementia,
led by Adjunct Professor Eino Solje.
========================================================================== Story Source: Materials provided by University_of_Eastern_Finland. Note: Content may be edited for style and length.
========================================================================== Journal Reference:
1. Sami Heikkinen, Antti Cajanus, Kasper Katisko, Pa"ivi Hartikainen,
Ritva
Vanninen, Annakaisa Haapasalo, Johanna Kru"ger, Anne M. Remes,
Eino Solje. Brainstem atrophy is linked to extrapyramidal symptoms
in frontotemporal dementia. Journal of Neurology, 2022; DOI:
10.1007/s00415- 022-11095-x ==========================================================================
Link to news story:
https://www.sciencedaily.com/releases/2022/04/220407101048.htm
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