New testing, treatment strategies for dementia presented at International conference

By Carol Hyman

WHAT: The 5th International Conference on Frontotemporal Dementia

WHO: presented by the Department of Neurology, University of California, San Francisco

WHERE: Grand Hyatt Hotel at Union Square in San Francisco

WHEN: Wed., Sept. 6- Fri., Sept. 8

The 5th International conference on Frontotemporal Dementia a is three-day conference with one day devoted to caregivers, family members and interested laypersons, and three days dedicated to scientific sessions.

Topics will include the molecular basis of frontotemporal dementia (FTD), animal models of disease, behavioral manifestations, diagnostic testing, and biomarker assessments, including neuroimaging, and genetics. Course directors are Bruce Miller, MD, UCSF Professor of Neurology and Director of the UCSF Memory and Aging Center, and Howard Rosen, MD, UCSF Assistant “Professor of Neurology.

The conference will bring together more than 500 neurologists, psychologists, and other experts in this field.  Highlights include:

Wednesday, Sept. 6:

• Diagnostic Testing, Now and in the future This session, led by Tiffany Chow, MD, Assistant Professor of Neurology and Geriatric Psychiatry, University of Toronto, will discuss how to diagnose frontotemporal dementia and will explore the role that neuroimaging plays in diagnosis. (9:30 a.m.)

• Blocking tau accumulation. Abnormalities in the microtubule-associated protein tau are implicated in a variety of neurodegenerative diseases, ranging from frontotemporal dementia to Alzheimer’s disease. There is not yet a consensus on the best strategy for targeting tau to treat these conditions. Reducing tau expression or changing tau-related metabolic pathways will be explored in this session. (10:20 a.m.)

• The FTD Trajectory: Stages, behaviors and functional decline. Frontotemporal dementia (FTD) refers to a group of disorders caused by progressive loss of brain cells within the frontal and anterior temporal brain regions. These areas normally control complex social/interpersonal behaviors, judgment, emotional responses and language. The symptoms differ from Alzheimer’s disease because Alzheimer’s neuropathology first affects a different part of the brain, the hippocampus, which controls memory, helping people to update reality from minute to minute. The major subtypes of FTD relate to whether behavior or language functions are first impaired.  In the early stages, symptom differences in these two groups are the greatest and require different approaches, which will be discussed. This session is led by Erik Roberson, MD, PHD, UCSF Assistant Professor of Neurology. (3:10 p.m.)

• Service delivery and FTD: what America doesn’t understand.  While the healthcare community and society at large have an understanding of Alzheimer’s disease, treatment and management of FTD remains unknown to many primary care physicians and is seen as rare. FTD is difficult to diagnose, and often patients get an incorrect diagnosis. Due to the “early onset” (under 65) nature, families face different issues than those with an Alzheimer’s patient. These issues include loss of employment, caring for young children still at home, and significant financial and emotional stress for the whole family. The presentation focuses on the special educational and service needs of individuals with FTD and their families and caregivers. This session is led by Darby Morhardt, MSW, LCSW, Northwestern University Assistant Professor of Cognitive Neurology. (3:30)

• Art Show featuring works of art created by FTD patients from the UCSF Memory and Aging Center will be presented at Yerba Buena Gardens. Some of the artists and their families will be in attendance. (6-8 p.m.)

Thursday, Sept. 7:

• Genetics -window into early changes. As therapeutic intervention becomes available, early diagnosis of neurodegenerative diseases becomes increasingly important. Inherited autosomal dominant neurodegenerative diseases provide an opportunity for studying patients from pre-symptomatic to established stages of the disease. (9:10 a.m.)

• Frontotemporal dementia: Impact on emotion and socioemotional behavior. Researchers at UC Berkeley and UCSF have studied more than 100 patients and age-matched normal controls who participated in an extensive laboratory-based assessment of emotional functioning that focuses on multiple emotional processes using a wide-variety of techniques to detect emotion. Findings from this research have refined understanding of the ways that emotional functioning is altered in FTD expanding and clarifying items in the research criteria such as “emotional blunting” and “lack of empathy” that were largely derived from in-clinic behavior and caregiver reports. This session will be led by Robert Levenson, PhD UC Berkeley Professor of Psychology. (1 p.m.)

• Behavior-Art and FLTD. Bruce Miller, MD, director of the UCSF Memory and Aging Center and expert on dementia and art, will discuss his research (1:20 p.m.)

• Behavior-Personality. A major misdiagnosis is the general misconception that dementia is always a disorder of cognition, while in reality altered social behavior and changes in personality are often the first neurological signs of dementia. Kate Rankin, PhD, UCSF Assistant Professor of Neurology will discuss a piloted clinician rating instrument to tally spontaneous social behaviors during clinical evaluations. (1:40 p.m.)

• What FTD Reveals about the Neurobiology of Morality. FTD is characterized by difficulty modulating social behavior. Patients lack social propriety and may perform sociopathic acts. In addition, they may lack empathy toward others. UCLA neurology professor Mario Mendez, MD, will discuss his study and results of administering an inventory of moral knowledge and two moral dilemmas to 26 patients with the frontal variant of FTD, 26 patients with Alzheimer’s and 26 normal controls. (4:40 p.m.)

Friday, Sept. 8

• FLTD: Clinical Features among those with Progranulin Mutations. Michael Hutton, PhD, and Brad Boeve, MD, from the Mayo Clinics and colleagues recently identified mutations in the gene encoding progranulin (PGRN) in families with frontotemporal dementia and parkinsonism. They now report the clinical characterization of six kindreds, each with different mutations in PGRN. Dr. Boeve will discuss the findings. (9:10 a.m.)

• Utility of Supportive Features in the Clinical Diagnosis of Frontotemporal Lobar Regeneration (FTLD). Current FTLD criteria include required and supportive features for three distinct clinical syndromes: frontotemporal dementia (FTD),  semantic dementia (SD) and progressive nonfluent aphasia (PA). Despite widespread use of these criteria, little is known about the relative utility of supportive features for accurate diagnosis. Katya Rascovsky, PhD,  from Neuropsychology at UCSF, will discuss how she and other researchers went about empirically assessing the utility of supportive features.(4:20)

• Panel Discussion. Adam Boxer, MD, UCSF Assistant Professor of Neurology will lead a discussion on treatment of FTD to conclude the conference (5 p.m.)
For a full agenda and brochure for the conference go to:  Agenda


NOTE: Media interested in attending or interviewing any of the participants should call Carol Hyman, (415) 476-2557 to make arrangements.