Precision Medicine for Frontotemporal Dementia
Introduction - What is Frontotemporal Dementia?
Frontotemporal Dementia (FTD) is a range of conditions for which the nerves in the frontal and temporal lobes of the brain are damaged. FTD occurs when abnormal forms of protein, including Tau, build up in nerve cells. These proteins can cause clumps that can kill nerve cells. Frontotemporal Dementia can cause a deficit in behaviours, language, and executive function. It normally occurs in patients aged less than 65 and is one of the most common forms of dementia across all age groups.
There are two types of Frontotemporal Dementia disorder: behavioral variant frontotemporal dementia (bvFTD) and primary progressive aphasia (PPA). Behavioral Variant Frontotemporal Dementia, the most common form of FTD, involves changes in personality and behaviour. In the case of bvFTD, the frontal lobes of the brain are affected first. Some symptoms of bvFTD may include decreased empathy, lack of interest in things they previously liked, alteration in food preferences, etc. The second type of FTD, Primary Progressive Aphasia, exhibits a decline in language and writing skills. Patients may have a hard time expressing themselves while speaking or writing. Some symptoms of PPA are slowing down, pausing or stopping while speaking, difficulty finding the right word, mispronouncing words, etc. In this case, the temporal lobes of the brain are affected first. PPA can further be divided into two subtypes: svPPa or the loss of ability to comprehend words in spoken sentences, and nfvPPA, which is when the patient’s speech becomes hesitant.
Current Treatment
Frontotemporal dementia can worsen over time and the speed at which it declines is different for every person. There is currently no cure or treatment to stop the progression of FTD, but there are a few ways to manage the symptoms. Most treatments are focused on the management of behavioral symptoms. These treatments can include changing some habits to have a healthier lifestyle, improving their social connection, and indulging in physical activities. However, the problem with these nonpharmacological interventions for the management of dementia is that they can worsen the medical disease for elderly patients. Due to these problems, there is a rise in the consideration of the usage of precision medicine.
Behaviour varies disturbance can be controlled by the usage of medication such as risperidone, olanzapine, and quetiapine. These medications can help the patients manage their symptoms, but it can be risky for patients as it also has some side effects. In short, low usage of certain drugs may be helpful to manage the symptoms, but they should be used with caution because they can have certain side effects.
Precision Medicine
The usage of precision medicine for the treatment of FTD is now possible due to the advanced development of molecular biology and other neurosciences. Precision medicine, sometimes known as "personalized medicine", improves the efficiency of illness prevention by looking at a patient’s genes or proteins while minimizing the side effects in those who are less likely to react to a specific medication. It is currently an active area of research in clinical and scientific areas.
Precision medicine offers the potential to enable doctors to design extremely selective and effective treatments for persons suffering from medical diseases with few adverse effects. Precision medicine is being applied in the diagnosis and treatment of FTD at the moment. However, the precision medicine approach to FTD treatment response and the clinical process is just getting started. Due to the fact that Precision Medicine is strongly reliant on the individual's genetics, collaboration amongst parents, families, and specialists is crucial for identifying the pathogenic pathways that cause FTD and developing novel therapies for optimal precision medicine application.