JNNP: Hereditary Frontotemporal Dementia and the Effects of Exercises in High-Risk Populations: A GENFI Study

Frontotemporaldementia (FTD) refers to the dementia syndrome in which middle-aged and elderly patients slowly develop personality changes, speech disorders and behavioral abnormalities, neuroimaging shows frontotemporal lobe atrophy, and pathological examination does not find Pick body and Pick cell dementia syndrome
.

Frontotemporal dementia is a group of dementia syndromes characterized by frontotemporal lobe atrophy, including Pick's disease and Pick syndrome with similar clinical manifestations.

Frontotemporaldementia (FTD) refers to the dementia syndrome in which middle-aged and elderly patients slowly develop personality changes, speech disorders and behavioral abnormalities, neuroimaging shows frontotemporal lobe atrophy, and pathological examination does not find Pick body and Pick cell dementia syndrome

People have proposed different attempts to adjust the effect of exercises in repeated tests
.

However, recent studies have shown that the phenomenon of exercise effects can provide useful information

People have proposed different attempts to adjust the effect of exercises in repeated tests

All participants (317 NC, 327 PMC, and 159 affected mutation carriers (AMC)) were recruited through GENFI from January 2012 to March 2018
.

Among the 803 participants, 471 visited twice; 249 visited three times; and 108 visited four times

All participants (317 NC, 327 PMC, and 159 affected mutation carriers (AMC)) were recruited through GENFI from January 2012 to March 2018

The effect of mutant genes on the overall cognitive test scores of NC and PMC

In the first five interviews, NC's average global cognitive test score has increased =
.

When investigating different cognitive domains, the effect of practice was found in all domains except visual construction during the first 1-3 interviews

Similar to PMC-C9, compared with NC, in the first to third visits of PMC, the practice effect of PMC with prenucleoprotein (GRN) mutations near the onset is lower
.

However, PMC-GRN, which was close to onset, initially seemed to have a training effect, but did not improve its performance at the third visit

The effects of repeated cognitive assessment exercises in patients with pre-hereditary symptoms or symptomatic FTD and family members of non-mutation carriers were discussed
.

The effect of practice has never been studied in the context of FTD before

The effects of repeated cognitive assessment exercises in patients with pre-hereditary symptoms or symptomatic FTD and family members of non-mutation carriers were discussed

Bar graph showing the number of participants per visit

The scores measured after the AMC repeat test may include "hidden" exercise effects, so the real cognitive dysfunction will actually be greater than recorded in the test scores
.
The cognitive function of FTD is expected to decline during the test interval used in this study (an average of 1.
3 years)
.
The potential lack of exercise effects in clinical FTD cannot be evaluated with the current settings, but it can be resolved if retesting is performed within a few days or weeks after the first evaluation
.
In addition to the PMC that is close to the onset, the training effect of PMC-C9 whose symptoms are expected to be onset for more than 5 years is also lower than that of NC.
This cannot be explained by the early conversion to the symptom stage
.
C9orf72 expansion carriers have slow progress in brain atrophy, and some patients have a fairly long course of disease
.
C9orf72 amplified carriers’ brain lesions already exist in early adulthood, and the potential neurodevelopmental effects may lead to a longer prodromal period of PMC-C9
.
The results of previous studies have shown that there is no difference between the cognitive ability of PMC patients and NC patients when they are very close to the onset of the disease.
The diagnostic potential of exercise effects and whether they can be used to distinguish PMC-C9 from NC remains to be explored
.

The scores measured after the AMC repeat test may include "hidden" exercise effects, so the real cognitive dysfunction will actually be greater than recorded in the test scores
.
The cognitive function of FTD is expected to decline during the test interval used in this study (an average of 1.
3 years)
.

With the continuous development of the FTD research field and the continuous emergence of treatment opportunities, the knowledge of the different stages of the disease is very demanding
.
In the process of preparing for clinical trials, the effect of exercise may have an impact on the interpretation of longitudinal changes in cognitive performance, because it may affect the estimated treatment effect after intervention, especially in the early stages of the disease
.
In future clinical trials, it is also necessary to consider the existence of exercise effects
.

Because it may affect the estimated treatment effect after intervention, especially in the early stages of the disease course
.
In future clinical trials, it is also necessary to consider the existence of exercise effects
.
Öijerstedt  L ,  Andersson  C ,  Jelic  V Öijerstedt  L Öijerstedt Andersson  C Andersson Jelic  V Jelic , et al Practice effects in genetic frontotemporal dementia and at-risk individuals: a GENFI study Journal of Neurology, Neurosurgery & Psychiatry  Published Online First:  18 August 2021.
  Published Online First: doi:  10.
1136/jnnp-2021-327005 doi:

 

 

 

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