Dr Lucio D’Anna is a Consultant Neurologist at the Department of Stroke & Neurosciences at Imperial College London NHS Trust. He is also Honorary Senior Lecturer at the Division of Brain Sciences, Imperial College London.
The main symptoms are a progressive change in personality and behaviour or progressive deterioration in language abilities. There are three forms of FTD: behavioral variant frontotemporal dementia which affects personality and behaviour, primary progressive aphasia which affects speech at first and then behaviour and progressive nonfluent aphasia which causes people to lose their ability to recall and speak words.
As the disease progresses, it becomes increasingly difficult for people to plan or organize activities, behave appropriately in social or work settings, interact with others, and care for oneself, resulting in increasing dependency on caregivers.
At Dementech Neurosciences, we have the possibility to assess in vivo tau protein aggregates using a special type of brain scan called positron emission tomography (PET), which can be used to measure chemical changes within the brain and consequently study the functions of the brain. This novel imaging tool will enable early diagnosis of FTD before extensive cell loss and symptoms become evident. Additionally, Tau PET can also serve as an indicator of treatment efficacy for interventions aimed at preventing tau aggregate formation.
We also provide genetic screening and counselling for the known genes associated to the familial forms of FTD. Some people with FTD have a family history of dementia and the condition may be inherited in some of these families. Directly inherited forms of FTD are thought to account for around 10-20% of all cases of the condition. Genes that are known to cause FTD include MAPT gene (tau), progranulin (or GRN) gene or a gene called C9ORF72.
Mutations in the tau gene can cause the tau protein to behave abnormally, forming toxic clumps that can damage brain cells. We still need to understand more about how mutations in progranulin and C9ORF72 cause the disease. The C9ORF72 gene can cause individuals to develop motor neurone disease or FTD or both conditions and may affect members of the same family differently.
At Dementech Neurosciences, we offer a multidisciplinary approach to treat all the variety of symptoms of FTD. We have in-house speech and language therapist, occupational therapist, dietitian, psychologist and psychiatrist to manage effectively cognitive symptoms.
Moreover, we offer the opportunity to participate in clinical trials testing novel pharmacological intervention, before they become available to the public, aiming to delay the progression of the disease. Caregivers may experience significant stresses and have a high level of burden; therefore we also offer caregiver support.