Temporal order of clinical and biomarker changes in familial frontotemporal dementia.

Staffaroni, AMORCID logo; Quintana, MORCID logo; Wendelberger, BORCID logo; Heuer, HW; Russell, LLORCID logo; Cobigo, YORCID logo; Wolf, A; Goh, SM; Petrucelli, L; Gendron, TFORCID logo; +95 more...Heller, CORCID logo; Clark, AL; Taylor, JCORCID logo; Wise, A; Ong, E; Forsberg, L; Brushaber, D; Rojas, JC; VandeVrede, LORCID logo; Ljubenkov, P; Kramer, J; Casaletto, KB; Appleby, B; Bordelon, Y; Botha, HORCID logo; Dickerson, BC; Domoto-Reilly, KORCID logo; Fields, JA; Foroud, TORCID logo; Gavrilova, R; Geschwind, DORCID logo; Ghoshal, NORCID logo; Goldman, J; Graff-Radford, J; Graff-Radford, N; Grossman, M; Hall, MG; Hsiung, GORCID logo; Huey, ED; Irwin, D; Jones, DTORCID logo; Kantarci, K; Kaufer, D; Knopman, DORCID logo; Kremers, W; Lago, AL; Lapid, MIORCID logo; Litvan, IORCID logo; Lucente, D; Mackenzie, IR; Mendez, MFORCID logo; Mester, C; Miller, BL; Onyike, CU; Rademakers, RORCID logo; Ramanan, VKORCID logo; Ramos, EM; Rao, M; Rascovsky, K; Rankin, KP; Roberson, EDORCID logo; Savica, R; Tartaglia, MCORCID logo; Weintraub, S; Wong, B; Cash, DMORCID logo; Bouzigues, AORCID logo; Swift, IJ; Peakman, GORCID logo; Bocchetta, MORCID logo; Todd, EG; Convery, RS; Rowe, JBORCID logo; Borroni, B; Galimberti, DORCID logo; Tiraboschi, P; Masellis, M; Finger, E; van Swieten, JC; Seelaar, HORCID logo; Jiskoot, LC; Sorbi, SORCID logo; Butler, CR; Graff, C; Gerhard, AORCID logo; Langheinrich, TORCID logo; Laforce, RORCID logo; Sanchez-Valle, RORCID logo; de Mendonça, A; Moreno, F; Synofzik, M; Vandenberghe, R; Ducharme, S; Le Ber, I; Levin, J; Danek, AORCID logo; Otto, M; Pasquier, FORCID logo; Santana, I; Kornak, J; Boeve, BFORCID logo; Rosen, HJ; Rohrer, JD; Boxer, ALORCID logo; Frontotemporal Dementia Prevention Initiative (FPI) Investigator and (2022) Temporal order of clinical and biomarker changes in familial frontotemporal dementia. Nature medicine, 28 (10). pp. 2194-2206. ISSN 1078-8956 DOI: 10.1038/s41591-022-01942-9
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Unlike familial Alzheimer's disease, we have been unable to accurately predict symptom onset in presymptomatic familial frontotemporal dementia (f-FTD) mutation carriers, which is a major hurdle to designing disease prevention trials. We developed multimodal models for f-FTD disease progression and estimated clinical trial sample sizes in C9orf72, GRN and MAPT mutation carriers. Models included longitudinal clinical and neuropsychological scores, regional brain volumes and plasma neurofilament light chain (NfL) in 796 carriers and 412 noncarrier controls. We found that the temporal ordering of clinical and biomarker progression differed by genotype. In prevention-trial simulations using model-based patient selection, atrophy and NfL were the best endpoints, whereas clinical measures were potential endpoints in early symptomatic trials. f-FTD prevention trials are feasible but will likely require global recruitment efforts. These disease progression models will facilitate the planning of f-FTD clinical trials, including the selection of optimal endpoints and enrollment criteria to maximize power to detect treatment effects.


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