LATE diseases: a new form of dementia definition

Working with colleagues from the University of Pennsylvania, researchers at the University of Kentucky have discovered that they can distinguish the subtypes of dementia that cause brain disease.

“We have for the first time created the criteria that can distinguish Frontal Temporal Dementia (FTD) from common Alzheimer’s “mimic” LATE disorders,” said Dr. Peter Nelson of the Sanders Brown Aging Center at the University of Kentucky. It was They rigorously tested the standards. Investigation Recently published Brain: Journal of Neurology.. The first author of the paper was John L Robinson at the University of Pennsylvania and the corresponding author was Nelson.

The study was the result of the work of a large group funded and organized by the National Institute for Aging, which is part of the National Institutes of Health (NIH). Kentucky. LATE is an abbreviation for “marginal predominant age-related TDP-43 encephalopathy”. LATE is a disease with symptoms like Alzheimer’s, which is called “dementia”, but is caused by various underlying processes in the brain.

LATE is important because it affects millions of people, about 40% of those over the age of 85. How was it perceived? Researchers around the world have found that many older people who died have dementia symptoms at the time of autopsy, without the overt features of Alzheimer’s disease (“plaques and tangles”) in the brain. New research has shown that the protein TDP-43 contributed to the phenomenon.

“Dozens of different viruses and bacteria can cause pneumonia,” Nelson explained. “So why do we think there is only one cause of dementia?”

With that question in mind, Nelson et al. set out to define diagnostic criteria and other guidelines to further this future study of this newly named dementia.

“We thought that the aging-related decline in memory and thought meant a disease called Alzheimer’s disease. So what we called Alzheimer’s disease is actually It turns out that there are many different states, often combined.

“This raises some issues: is it important to classify and distinguish between those states, and if so, how do you do that?” Nelson said. “Cancer inspires us, because the field is decades before the study of dementia. In cancer, cancers are vastly different and respond differently to treatments. It is worth understanding its complexity, as is the different diseases that cause dementia. One type of protein deposit in the brain called TDP-43 is very harmful to the brain and amnesia. It causes dementia syndrome with problems of thinking and thinking.”

As the researchers said in this recent study, “There is general agreement that millions of people around the world are affected by age-related TDP-43 proteinosis. There are some serious gaps in degenerative disease classification guidelines, which is why scientists wanted to closely compare frontotemporal dementia (FTD) with the mimicking disease LATE. We have found that the two actually have different pathological features.

“Until we can define the disease, finding a cure is very difficult. We now have a better foundation to support our efforts towards treatment,” Nelson said.

With these findings, Nelson looks forward to working on the first clinical trial of LATE with his British colleague Dr. Greg Jichach. “This is a very exciting opportunity to test a drug that could stop the disease and treat our research volunteers here in the UK,” Nelson said.

reference: Robinson JL, Porta S, Garrett FG, etc. Marginally dominant age-related TDP-43 encephalopathy differs from frontotemporal lobe degeneration. brain. 2020:awaa219. Doi: 10.1093 / brain / awaa219

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