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Invited Article: The Alzheimer disease–frontotemporal lobar degeneration spectrum

From the Neurodegenerative Brain Diseases Group, Department of Molecular Genetics, VIB; Laboratory of Neurogenetics, Institute Born-Bung; and University of Antwerp, Antwerpen, Belgium.

Address correspondence and reprint requests to Prof. Dr. Christine Van Broeckhoven, VIB–Department of Molecular Genetics, Neurodegenerative Brain Diseases Group, University of Antwerp–CDE, Universiteitsplein 1, B-2610, Belgium christine.vanbroeckhoven{at}ua.ac.be

Alzheimer disease (AD) and frontotemporal lobar degeneration (FTLD) are two frequent forms of primary neurodegenerative dementias. Despite distinctive clinical diagnostic criteria for both brain disorders, differential diagnosis is often complicated by overlapping symptomatology. As we learn more about brain pathology and genetic makeup underlying these dementia disorders, evidence is accumulating for a clinical, pathologic, and genetic spectrum of neurodegenerative brain diseases in which AD and FTLD occur along one continuum. This has important implications for molecular diagnostic testing and genetic counseling of patients with dementia. In this light, we review the molecular genetics of AD and FTLD assessing how AD genes can be implicated in FTLD and conversely FTLD genes in AD, by modifying disease susceptibility. Herein, we focus on recent exciting findings providing further support for an AD-FTLD spectrum.

Abbreviations: AD = Alzheimer disease; ALS = amyotrophic lateral sclerosis; CAA = cerebral amyloid angiopathy; FTLD = frontotemporal lobar degeneration; FTLD-U = FTLD with tau-negative, ubiquitin-positive pathology; LOF = loss of function; NMD = nonsense mediated mRNA decay.

The research described by the authors was in part funded by the Alzheimer Association USA; the Association for Frontal Temporal Dementia, USA; and the EU integrated project APOPIS, the InterUniversity Attraction Poles (IAP) program P5/19 and P6/43 of the Belgian Federal Science Policy office, the Foundation for Alzheimer Research (SAO/FRMA), the Medical Foundation Queen Elisabeth, the Fund for Scientific Research–Flanders (FWO-F), the Institute for the Promotion of Innovation through Science and Technology in Flanders (IWT-F), and the Special Research Fund (BOF) of the University of Antwerp, Belgium. J.v.d.Z. holds a PhD fellowship of the IWT-F. The FWO-F provided a postdoctoral fellowship to K.S.

Disclosure: The authors report no disclosures.

Received February 27, 2008. Accepted in final form June 19, 2008.