Differences and similarities between familial and sporadic frontotemporal dementia: an Italian single-center cohort study
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Introduction: The possibility to generalize our understandings on treatments and assessments to both familial frontotemporal dementia (f‐FTD) and sporadic FTD (s‐FTD) is a fundamental perspective for the near future, considering the constant advancement in potential disease‐modifying therapies that target particular genetic forms of FTD. We aimed to investigate differences in clinical features, cerebrospinal fluid (CSF), and blood‐based biomarkers between f‐FTD and s‐FTD. Methods: In this longitudinal cohort study, we evaluated a consecutive sample of symptomatic FTD patients, classified as f‐FTD and s‐FTD according to Goldman scores (GS). All patients underwent clinical, behavioral, and neuropsychiatric symptom assessment, CSF biomarkers and serum neurofilament light (NfL) analysis, and brain atrophy evaluation with magnetic resonance imaging. Results: Of 570 patients with FTD, 123 were classified as f‐FTD, and 447 as s‐FTD. In the f‐FTD group, 95 had a pathogenic FTD mutation while 28 were classified as GS = 1 or 2; of the s‐FTD group, 133 were classified as GS = 3 and 314 with GS = 4. f‐FTD and s‐FTD cases showed comparable demographic features, except for younger age at disease onset, age at diagnosis, and higher years of education in the f‐FTD group (all P < .05). f‐FTD showed worse behavioral disturbances as measured with Frontal Behavioral Inventory (FBI) negative behaviors (14.0 ± 7.6 vs. 11.6 ± 7.4, P = .002), and positive behaviors (20.0 ± 11.0 vs. 17.4 ± 11.8, P = .031). Serum NfL concentrations were higher in patients with f‐FTD (70.9 ± 37.9 pg/mL) compared to s‐FTD patients (37.3 ± 24.2 pg/mL, P < .001), and f‐FTD showed greater brain atrophy in the frontal and temporal regions and basal ganglia. Patients with f‐FTD had significantly shorter survival than those with s‐FTD ( P = .004). Discussion: f‐FTD and s‐FTD are very similar clinical entities, but with different biological mechanisms, and different rates of progression. The parallel characterization of both f‐FTD and s‐FTD will improve our understanding of the disease, and aid in designing future clinical trials for both genetic and sporadic forms of FTD. Highlights: Do clinical features and biomarkers differ between patients with familial frontotemporal dementia (f‐FTD) and sporadic FTD (s‐FTD)? In this cohort study of 570 patients with FTD, f‐FTD and s‐FTD share similar demographic features, but with younger age at disease onset and diagnosis in the f‐FTD group. f‐FTD showed higher serum neurofilament light concentrations, greater brain damage, and shorter survival, compared to s‐FTD. f‐FTD and s‐FTD are very similar clinical entities, but with different cognitive reserve mechanisms and different rates of progression.
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A large cross-sectional study concluded that serum NfL concentration is higher in genetic bvFTD than in sporadic bvFTD.
“a large cross-sectional study concluded that serum NfL concentration is higher in genetic bvFTD (Benussi et al., 2022)”
From The pursuit for markers of disease progression in behavioral variant frontotemporal dementia: a scoping review to optimize outcome measures for clinical trials (2024) · cites this paper as Benussi et al., 2022
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- [43]Benussi A, Karikari TK, Ashton N, et al. Diagnostic and prognostic value of serum NfL and p‐Tau 181 in frontotemporal lobar degeneration. J Neurol Neurosurg Psychiatry. 2020; 91(9): 960‐ 967. 10.1136/jnnp-2020-323487 32611664 · DOI
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Fieldhouse, J. L. P., van Paassen, D. N., van Engelen, M.-P. E., De Boer, S. C. M., Hartog, W. L., Braak, S., Schoonmade, L. J., Schouws, S. N. T. M., Krudop, W. A., Oudega, M. L., et al. (2024) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2024.1382593 · Cited by 8 · see citing works
- Authors
- Benussi, A., Libri, I., Premi, E., Alberici, A., Cantoni, V., Gadola, Y., Rivolta, J., Pengo, M., Gazzina, S., Calhoun, V. D., Gasparotti, R., Zetterberg, H., Ashton, N. J., Blennow, K., Padovani, A., & Borroni, B.
- Affiliations
- Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT)
- University of Brescia (IT)
- Mind Research Network (US)
- Sahlgrenska University Hospital (SE)
- King's College London (GB)
- Corresponding author
- Borroni, Barbara
- ORCID
- Venue
- Alzheimer's & Dementia: Translational Research & Clinical Interventions
- Publisher
- Wiley
- Published
- 2022-01
- Volume
- 8
- Issue
- 1
- Pages
- e12326-e12326
- ISSN
- 2352-8737 (ISSN-L)
- PMC
- PMC9310192
- OpenAlex
- W4287313258
- Cited by
- 14
- References
- 49
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 4 · 2023: 3
- FWCI
- 1.95
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Alzheimer s & Dementia Translational Research & Clinical Interventions (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- ArTS Archivio della ricerca di Trieste (University of Trieste https://www.units.it/) (submittedVersion, cc-by-nc)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Institutional Research Information System (Università degli Studi di Brescia) (submittedVersion)
- Funders
- National Science Foundation (2016615, 2112455)
- Alzheimer's Association (ADSF-21-831377-C, 21-831376 -C, ADSF‐21‐831376‐C, #ADSF-21-831381-C, JPND2019-466-236, -21-831381-C, -21- 831377-C)
- Alzheimer's Drug Discovery Foundation (2016862, FO2017-0243, 201809, ADSF-21-831381-C, 2017-00915, #ALFGBG-715986, 201809–2016862, ADSF-21-831377-C, 860197, JPND2019-466-236, JPND2021-00694, 201809-2016615, #ADSF-21-831376-C, #RDAPB‐201809‐2016615, AF-742881)
- Familjen Erling-Perssons Stiftelse (#FO2017-0243, FO2019-0228, 860197)
- Stiftelsen för Gamla Tjänarinnor (860197, FO2019‐0228)
- European Commission (JPND2021‐00694, JPND2019‐466‐236, 860197)
- Fondazione Cariplo (2021-1516)
- Ministero della Salute (2018-, RF-2018-12366665, RF-2018)
- Hjärnfonden (FO2017‑0243, FO2017, ALFGBG-715986, FO2019‐0228, JPND2019-466-236)
- Vetenskapsrådet (860197, 2017-00915, (#ALFGBG-715986, 681712, 2018-, JPND2019-466-236, FO2017-0243, 2018-02532, JPND2021-00694)
- UK Dementia Research Institute (#2017-00915, ALFGBG-715986, RDAPB-201809-2016615, FO2017-0243, -201809-2016615)
- Associazione Italiana Ricerca Alzheimer (Airalzh-AGYR2020, AGYR2020)
- National Institutes of Health (2112455, 2018-02532)
- National Institute on Aging (R01AG068398, RF1AG063153)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Neurology › Amyotrophic Lateral Sclerosis Research
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Keywords
- familial frontotemporal dementia, sporadic frontotemporal dementia, cerebrospinal fluid biomarkers, serum neurofilament light, brain atrophy, behavioral problems, survival, disease-modifying therapy, Frontal Systems Behavior Scale, age of onset, Italian patients, disease progression prediction, neuropsychiatric symptoms
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