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Clinic, neuropathology and molecular genetics of frontotemporal dementia: a mini-review

机译:额颞痴呆的临床,神经病理学和分子遗传学:迷你审查

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摘要

Frontotemporal lobar degeneration (FTLD) represents a group of clinically, neuropathologically and genetically heterogeneous disorders with plenty of overlaps between the neurodegenerative mechanism and the clinical phenotype. FTLD is pathologically characterized by the frontal and temporal lobar atrophy. Frontotemporal dementia (FTD) clinically presents with abnormalities of behavior and personality and language impairments variants. The clinical spectrum of FTD encompasses distinct canonical syndromes: behavioural variant of FTD (bvFTD) and primary progressive aphasia. The later includes nonfluent/agrammatic variant PPA (nfvPPA or PNFA), semantic variant PPA (svPPA or SD) and logopenic variant PPA (lvPPA). In addition, there is also overlap of FTD with motor neuron disease (FTD-MND or FTD-ALS), as well as the parkinsonian syndromes, progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS). The FTLD spectrum disorders are based upon the predominant neuropathological proteins (containing inclusions of hyperphosphorylated tau or ubiquitin protein, e.g transactive response (TAR) DNA-binding protein 43?kDa (TDP-43) and fusedin-sarcoma protein in neurons and glial cells) into three main categories: (1) microtubule-associated protein tau (FTLD-Tau); (2) TAR DNA-binding protein-43 (FTLD-TDP); and (3) fused in sarcoma protein (FTLD-FUS). There are five main genes mutations leading clinical and pathological variants in FTLD that identified by molecular genetic studies, which are chromosome 9 open reading frame 72 (C9ORF72) gene, granulin (GRN) gene, microtubule associated protein tau gene (MAPT), the gene encoding valosin-containing protein (VCP) and the charged multivesicular body protein 2B (CHMP2B). In this review, recent advances on the different clinic variants, neuroimaging, genetics, pathological subtypes and clinicopathological associations of FTD will be discussed.
机译:额颞叶变性(FTLD)代表了一组临床,神经病理学和遗传异质性疾病,在神经退行性机制和临床表型之间有很多重叠。 FTLD的病理特征是额叶和颞叶萎缩。额颞叶痴呆(FTD)在临床上表现为行为和性格异常以及语言障碍变体。 FTD的临床范围包括独特的典型综合征:FTD的行为变异(bvFTD)和原发性进行性失语症。后者包括非流利/语法变体PPA(nfvPPA或PNFA),语义变体PPA(svPPA或SD)和隐身变体PPA(lvPPA)。此外,FTD与运动神经元疾病(FTD-MND或FTD-ALS)以及帕金森氏综合征,进行性核上性麻痹(PSP)和肾上腺皮质综合征(CBS)也存在重叠。 FTLD谱系疾病基于主要的神经病理学蛋白(包含高磷酸化的tau或泛素蛋白的内含物,例如神经元和神经胶质细胞中的交易应答(TAR)DNA结合蛋白43?kDa(TDP-43)和融合素肉瘤蛋白)分为三个主要类别:(1)微管相关蛋白tau(FTLD-Tau); (2)TAR DNA结合蛋白43(FTLD-TDP); (3)融合在肉瘤蛋白(FTLD-FUS)中。分子遗传学研究确定了导致FTLD临床和病理变异的5个主要基因突变,分别是9号染色体开放阅读框72(C9ORF72)基因,颗粒蛋白(GRN)基因,微管相关蛋白tau基因(MAPT),该基因编码含缬氨酸的蛋白(VCP)和带电荷的多囊泡体蛋白2B(CHMP2B)。在这篇综述中,将讨论FTD的不同临床变异,神经影像学,遗传学,病理亚型和临床病理学关联的最新进展。

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