cognitive and behavioral issues in psp, cbd, ftd, and ppa · psp, cbd, ftd, and ppa future...
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Bradley F. Boeve, M.D.
Division of Behavioral Neurology
Department of Neurology
Mayo Clinic
Rochester, Minnesota
Alzheimer’s Disease Research Center
Mayo Foundation
Bradley F. Boeve, M.D.Bradley F. Boeve, M.D.
Division of Behavioral NeurologyDivision of Behavioral Neurology
Department of Neurology Department of Neurology
Mayo ClinicMayo Clinic
Rochester, MinnesotaRochester, Minnesota
AlzheimerAlzheimer’’s Disease Research Centers Disease Research Center
Mayo FoundationMayo Foundation
Cognitive and Behavioral Issues in
PSP, CBD, FTD, and PPA
Cognitive and Behavioral Issues in Cognitive and Behavioral Issues in
PSP, CBD, FTD, and PPAPSP, CBD, FTD, and PPA
Cognitive and Behavioral Issues in
PSP, CBD, FTD, and PPAOutline
Cognitive and Behavioral Issues in Cognitive and Behavioral Issues in
PSP, CBD, FTD, and PPAPSP, CBD, FTD, and PPAOutlineOutline
• History
• Brain-Behavior Correlations
• The Syndromes/Disorders
• Management
• Resources
• Questions
• History
• Brain-Behavior Correlations
• The Syndromes/Disorders
• Management
• Resources
• Questions
HistoryHistoryHistory
PSP, CBD, FTD, and PPAHistory
PSP, CBD, FTD, and PPAPSP, CBD, FTD, and PPAHistoryHistory
• PSP – initially characterized in the 1960s
• CBD – initially characterized in the late 1960s
• PPA – initially characterized in 1982
– nonfluent variant
– semantic variant
• FTD – initially characterized in 1994
• PSP – initially characterized in the 1960s
• CBD – initially characterized in the late 1960s
• PPA – initially characterized in 1982
– nonfluent variant
– semantic variant
• FTD – initially characterized in 1994
PSP, CBD, FTD, and PPAHistory
PSP, CBD, FTD, and PPAPSP, CBD, FTD, and PPAHistoryHistory
• The 4 different disorders have been classically
considered to be distinct and separate
• Growing evidence that these are strikingly
similar, with one of the primary distinctions
being what parts of the brain are maximally
affected
• The 4 different disorders have been classically
considered to be distinct and separate
• Growing evidence that these are strikingly
similar, with one of the primary distinctions
being what parts of the brain are maximally
affected
Brain-Behavior CorrelationsBrainBrain--Behavior CorrelationsBehavior Correlations
PSP, CBD, FTD, and PPA Brain-Behavior Correlations
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA BrainBrain--Behavior CorrelationsBehavior Correlations
Templates
A B C
A
B
C
Thinking/Cognitive
A B C
A
B
C
Behavior
Language
PSP, CBD, FTD, and PPA Brain-Behavior Correlations
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA BrainBrain--Behavior CorrelationsBehavior Correlations
Memory - hippocampi
A B C
A
B
C
PSP, CBD, FTD, and PPA Brain-Behavior Correlations
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA BrainBrain--Behavior CorrelationsBehavior Correlations
“Emotional valence”
- amygdala
A B C
A
B
C
PSP, CBD, FTD, and PPA Brain-Behavior Correlations
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA BrainBrain--Behavior CorrelationsBehavior Correlations
Problem-solving,
reasoning, complex
decision-making -
dorsolateral frontal regions
A B C
A
B
C
PSP, CBD, FTD, and PPA Brain-Behavior Correlations
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA BrainBrain--Behavior CorrelationsBehavior Correlations
Socially appropriate
behavior, “theory of
mind” - ventromedial
frontal regions
A B C
A
B
C
PSP, CBD, FTD, and PPA Brain-Behavior Correlations
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA BrainBrain--Behavior CorrelationsBehavior Correlations
Motivation, spontaneous
actions - anterior cingulate
region
A B C
A
B
C
PSP, CBD, FTD, and PPA Brain-Behavior Correlations
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA BrainBrain--Behavior CorrelationsBehavior Correlations
A B C
A
B
C
Language - left frontal,
temporal, parietal regions
NamingNaming
““SpeechSpeech””
““SpeechSpeech””, ,
naming, naming,
comprecompre--
hensionhension
CompreCompre--
hensionhension, ,
namingnaming
PSP, CBD, FTD, and PPA Brain-Behavior Correlations
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA BrainBrain--Behavior CorrelationsBehavior Correlations
C B A
A
B
C
Prosody - right frontal,
temporal, parietal regions
PSP, CBD, FTD, and PPA Brain-Behavior Correlations
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA BrainBrain--Behavior CorrelationsBehavior Correlations
C B A
A
B
C
Visual recognition - right >
left temporal and occipital
regions
PSP, CBD, FTD, and PPA Brain-Behavior Correlations
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA BrainBrain--Behavior CorrelationsBehavior Correlations
Social disinhibition
Loss of empathy and insight
Change in food preferences
Hoarding of food
Utilization behavior
A B C
A
B
C
PSP, CBD, FTD, and PPA Brain-Behavior Correlations
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA BrainBrain--Behavior CorrelationsBehavior Correlations
Memory loss
A B C
A
B
C
PSP, CBD, FTD, and PPA Brain-Behavior Correlations
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA BrainBrain--Behavior CorrelationsBehavior Correlations
Executive dysfunction
Poor planning and judgement
Inability to multitask
A B C
A
B
C
PSP, CBD, FTD, and PPA Brain-Behavior Correlations
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA BrainBrain--Behavior CorrelationsBehavior Correlations
Loss of motivation
Tendency to sit, not initiative
conversations or actions
A B C
A
B
C
PSP, CBD, FTD, and PPA Brain-Behavior Correlations
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA BrainBrain--Behavior CorrelationsBehavior Correlations
A B C
A
B
C
Poor verbal expression
NamingNaming
““SpeechSpeech””Poor naming of objects
and people
PSP, CBD, FTD, and PPA Brain-Behavior Correlations
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA BrainBrain--Behavior CorrelationsBehavior Correlations
C B A
A
B
C
Aprosodia
Monotone voice
Unable to interpret inflections in
voice another person’s voice
PSP, CBD, FTD, and PPA Brain-Behavior Correlations
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA BrainBrain--Behavior CorrelationsBehavior Correlations
C B A
A
B
C
Visual agnosia
Unable to recognize objects and
people
PSP, CBD, FTD, and PPA Brain-Behavior Correlations
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA BrainBrain--Behavior CorrelationsBehavior Correlations
The Syndromes/DisordersThe Syndromes/DisordersThe Syndromes/Disorders
Progressive Supranuclear PalsyProgressive Supranuclear Palsy
Clinical Features Clinical Features
• symmetric rigidity and bradykinesia– axial > appendicular– levodopa unresponsive
• postural/gait instability– frequent falls
• extraocular movement dysfunction– saccadic pursuits– delayed, slowed saccades– supranuclear gaze palsy, particularly downgaze
• apathy, bradyphrenia
• symmetric rigidity and bradykinesia– axial > appendicular– levodopa unresponsive
• postural/gait instability– frequent falls
• extraocular movement dysfunction– saccadic pursuits– delayed, slowed saccades– supranuclear gaze palsy, particularly downgaze
• apathy, bradyphrenia
Corticobasal Syndrome/Corticobasal DegenerationCorticobasal Syndrome/Corticobasal Degeneration
Clinical Features Clinical Features
• Progressive course
• Asymmetric findings
• Limb rigidity
• Limb apraxia
•• Progressive courseProgressive course
•• Asymmetric findingsAsymmetric findings
•• Limb rigidityLimb rigidity
•• Limb apraxiaLimb apraxia
Progressive asymmetric rigidity and apraxiaProgressive asymmetric rigidity and apraxiaProgressive asymmetric rigidity and apraxia
Behavioral Variant Frontotemporal DementiaBehavioral Variant Frontotemporal Dementia
Clinical Features Clinical Features
• personality/behavioral changes• loss of empathy/sympathy
• loss of insight• apathy• social disinhibition• change in food preferences• poor judgement and planning
• personality/behavioral changes• loss of empathy/sympathy
• loss of insight• apathy• social disinhibition• change in food preferences• poor judgement and planning
Primary Progressive AphasiaPrimary Progressive Aphasia
Clinical Features Clinical Features
• Nonfluent– changes in speech/language
production
• Semantic
– loss of nouns and word meaning
• Nonfluent– changes in speech/language
production
• Semantic
– loss of nouns and word meaning
Frontotemporal Lobar DegenerationsFrontotemporal Lobar Degenerations
PSPPSP CBDCBD FTDFTD PPAPPA
ManagementManagementManagement
PSP, CBD, FTD, and PPA Management
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA ManagementManagement
Pharmacotherapy
Improve symptoms
Manage behaviors
Decrease injury risk
PharmacotherapyPharmacotherapy
Improve symptoms
Manage behaviors
Decrease injury risk
Non-Pharmacotherapy
Improve symptoms
Manage behaviors
Decrease injury risk
Improve caregiving strategies
NonNon--PharmacotherapyPharmacotherapy
Improve symptoms
Manage behaviors
Decrease injury risk
Improve caregiving strategies
Improve QOL for all involvedImprove QOL for all involved
PSP, CBD, FTD, and PPA Management
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA ManagementManagement
• Approach – ask patients and caregivers to list and then rank which symptoms/problems are most bothersome,
which allows the clinicians to tailor the management plan
• Problem list:
– Cognitive
– Neuropsychiatric
– Motor
– Speech/swallowing
– Sleep
•• Approach Approach –– ask patients and caregivers to list and then ask patients and caregivers to list and then
rank which symptoms/problems are most bothersome, rank which symptoms/problems are most bothersome,
which allows the clinicians to tailor the management planwhich allows the clinicians to tailor the management plan
•• Problem list:Problem list:
–– CognitiveCognitive
–– NeuropsychiatricNeuropsychiatric
–– MotorMotor
–– Speech/swallowingSpeech/swallowing
–– SleepSleep
PSP, CBD, FTD, and PPA Management
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA ManagementManagement
• There are no FTD-approved medications specifically
developed to impact PPA, CBD, FTD, and PPA
• There are few well-designed studies that have shown that any medication improves symptoms in any of these
disorders
• There is considerable debate among clinicians whether
any medications are worth using in patients with any of
these disorders
• Almost all medications to be discussed are expensive
and are associated with mild to severe side-effects
•• There are no FTDThere are no FTD--approved medications specifically approved medications specifically
developed to impact PPA, CBD, FTD, and PPAdeveloped to impact PPA, CBD, FTD, and PPA
•• There are few wellThere are few well--designed studies that have shown designed studies that have shown
that any medication improves symptoms in any of these that any medication improves symptoms in any of these
disordersdisorders
•• There is considerable debate among clinicians whether There is considerable debate among clinicians whether
any medications are worth using in patients with any of any medications are worth using in patients with any of
these disordersthese disorders
•• Almost all medications to be discussed are expensive Almost all medications to be discussed are expensive
and are associated with mild to severe sideand are associated with mild to severe side--effectseffects
Cognitive
Education/Counseling/Behavioral Management:
Stay physically, mentally, and socially active
Establish and maintain a daily routine
Religious use of a daily planner
CognitiveCognitive
Education/Counseling/Behavioral Management:
Stay physically, mentally, and socially active
Establish and maintain a daily routine
Religious use of a daily planner
PSP, CBD, FTD, and PPA Management
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA ManagementManagement
Cognitive (cont.)
Executive dysfunction, memory impairment:
? Carbidopa/levodopa, dopamine agonists
Sinemet®, Mirapex®, Requip®
? Cholinesterase inhibitorsAricept®, Exelon®, Razadyne®
? PsychostimulantsProvigil®, Nuvigil®, Ritalin®, Adderall®, Desoxyn®
? NMDA antagonistsNamenda®
Cognitive (cont.)Cognitive (cont.)
Executive dysfunction, memory impairment:
? Carbidopa/levodopa, dopamine agonists
Sinemet®, Mirapex®, Requip®
? Cholinesterase inhibitorsAricept®, Exelon®, Razadyne®
? PsychostimulantsProvigil®, Nuvigil®, Ritalin®, Adderall®, Desoxyn®
? NMDA antagonistsNamenda®
PSP, CBD, FTD, and PPA Management
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA ManagementManagement
Neuropsychiatric
Education/Counseling/Behavioral Management:
Develop tolerance and choose your battles!
Acknowledge and redirect; refrain from arguing
“Employ therapeutic fibs”
Support group involvement
Work with local psychologists and psychiatrists
NeuropsychiatricNeuropsychiatric
Education/Counseling/Behavioral Management:
Develop tolerance and choose your battles!
Acknowledge and redirect; refrain from arguing
“Employ therapeutic fibs”
Support group involvement
Work with local psychologists and psychiatrists
PSP, CBD, FTD, and PPA Management
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA ManagementManagement
Neuropsychiatric (cont.)
Disinhibition, socially inappropriate behavior, delusions:
? Selective serotonin reuptake inhibitorsCelexa®, Lexapro®, Paxil®, Prozac®, Remeron®, Zoloft®
? Atypical neurolepticsSeroquel®, Respirdal®, Zyprexa®
? AnticonvulsantsDepakote®, Neuronin®, Tegretol®
? Beta-blockersInderal®
Neuropsychiatric (cont.)Neuropsychiatric (cont.)
Disinhibition, socially inappropriate behavior, delusions:
? Selective serotonin reuptake inhibitorsCelexa®, Lexapro®, Paxil®, Prozac®, Remeron®, Zoloft®
? Atypical neurolepticsSeroquel®, Respirdal®, Zyprexa®
? AnticonvulsantsDepakote®, Neuronin®, Tegretol®
? Beta-blockersInderal®
PSP, CBD, FTD, and PPA Management
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA ManagementManagement
Neuropsychiatric (cont)
Apathy:
? Selective serotonin reuptake inhibitorsCelexa®, Lexapro®, Paxil®, Prozac®, Zoloft®
? PsychostimulantsProvigil®, Nuvigil®, Ritalin®, Adderall®, Desoxyn®
? Carbidopa/levodopa, dopamine agonistsSinemet®, Mirapex®, Requip®
? Cholinesterase inhibitorsAricept®, Exelon®, Razadyne®
Neuropsychiatric (cont)Neuropsychiatric (cont)
Apathy:
? Selective serotonin reuptake inhibitorsCelexa®, Lexapro®, Paxil®, Prozac®, Zoloft®
? PsychostimulantsProvigil®, Nuvigil®, Ritalin®, Adderall®, Desoxyn®
? Carbidopa/levodopa, dopamine agonistsSinemet®, Mirapex®, Requip®
? Cholinesterase inhibitorsAricept®, Exelon®, Razadyne®
PSP, CBD, FTD, and PPA Management
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA ManagementManagement
Motor
Parkinsonism:
? Carbidopa/levodopa, dopamine agonistsSinemet®, Mirapex®, Requip®
Deep brain stimulation (experimental)
Gait impairment/falls:
Gait assistance devices and PT
Power operated vehicle (POV)
MotorMotor
Parkinsonism:
? Carbidopa/levodopa, dopamine agonistsSinemet®, Mirapex®, Requip®
Deep brain stimulation (experimental)
Gait impairment/falls:
Gait assistance devices and PT
Power operated vehicle (POV)
PSP, CBD, FTD, and PPA Management
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA ManagementManagement
Speech/Swallowing
Dysarthria/nonfluent aphasia/apraxia of speech:
Speech therapy
? Carbidopa/levodopa, dopamine agonistsSinemet®, Mirapex®, Requip®
Dysphagia:
Swallowing study
Thick-It, pureed food, PEG tube
Speech/SwallowingSpeech/Swallowing
Dysarthria/nonfluent aphasia/apraxia of speech:
Speech therapy
? Carbidopa/levodopa, dopamine agonistsSinemet®, Mirapex®, Requip®
Dysphagia:
Swallowing study
Thick-It, pureed food, PEG tube
PSP, CBD, FTD, and PPA Management
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA ManagementManagement
Sleep Disorders
Insomnia
Daytime hypersomnia
Obstructive sleep apnea
Central sleep apnea
Restless legs syndrome
Periodic limb movements during sleep
* Discuss with primary MD, and in select cases, consider a formal sleep medicine evaluation and sleep study
Sleep DisordersSleep Disorders
Insomnia
Daytime hypersomnia
Obstructive sleep apnea
Central sleep apnea
Restless legs syndrome
Periodic limb movements during sleep
* Discuss with primary MD, and in select cases, consider a formal sleep medicine evaluation and sleep study
PSP, CBD, FTD, and PPA Management
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA ManagementManagement
Pathophysiology and
Implications for Future Therapies
Pathophysiology and Pathophysiology and
Implications for Future TherapiesImplications for Future Therapies
PSP, CBD, FTD, and PPA Pathophysiology and Implications for Future Therapies
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA Pathophysiology and Implications for Future TherapiesPathophysiology and Implications for Future Therapies
Tauopathies• Pick’s disease • Corticobasal degeneration• Progressive supranuclear palsy• Argyrophilic grain disease• Frontotemporal dementia with Parkinsonism associated with
mutations in microtubule associated protein tau on chromosome 17 (FTDP-17MAPT)
TDP-43opathies• Frontotemporal lobar degeneration (FTLD) with motor neuron
disease (MND)• Frontotemporal lobar degeneration (FTLD) with
ubiquitin/TDP-43-positive inclusions• Frontotemporal dementia with Parkinsonism associated with
mutations in progranulin on chromosome 17 (FTDP-17PGRN)
Tauopathies• Pick’s disease • Corticobasal degeneration• Progressive supranuclear palsy• Argyrophilic grain disease• Frontotemporal dementia with Parkinsonism associated with
mutations in microtubule associated protein tau on chromosome 17 (FTDP-17MAPT)
TDP-43opathies• Frontotemporal lobar degeneration (FTLD) with motor neuron
disease (MND)• Frontotemporal lobar degeneration (FTLD) with
ubiquitin/TDP-43-positive inclusions• Frontotemporal dementia with Parkinsonism associated with
mutations in progranulin on chromosome 17 (FTDP-17PGRN)
PSP, CBD, FTD, and PPA Pathophysiology and Implications for Future Therapies
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA Pathophysiology and Implications for Future TherapiesPathophysiology and Implications for Future Therapies
PSPPSP
FTDFTD
CBDCBD
PPAPPA
tautau TDPTDP--4343 amyloidamyloid
Dickey & Petrucelli, Expert Opin Ther Targets 2006
? ? TauopathyTauopathy therapiestherapies
•• Microtubule stabilizersMicrotubule stabilizers
•• tau kinase inhibitorstau kinase inhibitors
•• Hsp90 inhibitorsHsp90 inhibitors
•• tau aggregation inhibitorstau aggregation inhibitors
•• davunetidedavunetide
•• remberrember
PSP, CBD, FTD, and PPA Pathophysiology and Implications for Future Therapies
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA Pathophysiology and Implications for Future TherapiesPathophysiology and Implications for Future Therapies
Normal neuronNormal neuron Abnormal neuronAbnormal neuron
UbiquitinUbiquitin++
TDPTDP--43+43+
degradeddegradedproteinsproteins
progranulinprogranulin
wastewasteproteinsproteins
clumpedclumpedproteinsproteins
progranulinprogranulin
wastewasteproteinsproteins
PSP, CBD, FTD, and PPA Pathophysiology and Implications for Future Therapies
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA Pathophysiology and Implications for Future TherapiesPathophysiology and Implications for Future Therapies
PSP, CBD, FTD, and PPA Pathophysiology and Implications for Future Therapies
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA Pathophysiology and Implications for Future TherapiesPathophysiology and Implications for Future Therapies
Eval #1 Eval #2 Eval #3 Eval #4 Eval #5
worsening
Theoretical considerations for future experimental drug trialsTheoretical considerations for future experimental drug trials
PSP, CBD, FTD, and PPA Pathophysiology and Implications for Future Therapies
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA Pathophysiology and Implications for Future TherapiesPathophysiology and Implications for Future Therapies
Tx
Eval #1 Eval #2 Eval #3 Eval #4 Eval #5
worsening
Slowed progression with diseaseSlowed progression with disease--altering therapyaltering therapy
Theoretical considerations for future experimental drug trialsTheoretical considerations for future experimental drug trials
PSP, CBD, FTD, and PPA Pathophysiology and Implications for Future Therapies
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA Pathophysiology and Implications for Future TherapiesPathophysiology and Implications for Future Therapies
Tx
Eval #1 Eval #2 Eval #3 Eval #4 Eval #5
improvem
ent
Improvement with diseaseImprovement with disease--altering therapyaltering therapy
Theoretical considerations for future experimental drug trialsTheoretical considerations for future experimental drug trials
PSP, CBD, FTD, and PPA Research Protocol Participation
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA Research Protocol ParticipationResearch Protocol Participation
Consider participating in research studies!!Consider participating in research studies!!
Thank you!!Thank you!!
PSP, CBD, FTD, and PPA Future Directions
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA Future DirectionsFuture Directions
• Increase awareness among the public and health care professions that PSP, CBD, FTD, and PPA exist, are recognizable disorders, and can be diagnosed and managed
• Develop networks of patients, families, friends, and health careprofessionals to improve managing the day-to-day aspects of the disorders
• Increase federal and private funding for research, education, and counseling
This is where you can help!
•• Increase awareness among the public and health care professions Increase awareness among the public and health care professions that PSP, CBD, FTD, and PPA exist, are recognizable disorders, that PSP, CBD, FTD, and PPA exist, are recognizable disorders, and can be diagnosed and managedand can be diagnosed and managed
•• Develop networks of patients, families, friends, and health careDevelop networks of patients, families, friends, and health careprofessionals to improve managing the dayprofessionals to improve managing the day--toto--day aspects of the day aspects of the disordersdisorders
•• Increase federal and private funding for research, education, anIncrease federal and private funding for research, education, and d counselingcounseling
This is where you can help!This is where you can help!
PSP, CBD, FTD, and PPA Future Directions
PSP, CBD, FTD, and PPA PSP, CBD, FTD, and PPA Future DirectionsFuture Directions
• Refine the clinical, genetic, neuropsychological, radiologic, and pathologic characterization of the disorders that cause these disorders
• Improve our understanding of tau and TDP-43 protein physiology and pathophysiology so promising therapies can be developed and tested
• Identify and develop clinical, laboratory, neuropsychological, and radiologic measures for future therapeutic drug trials
Ultimately prevent, delay the onset, and slow the progression of the disorders that cause PSP, CBD, FTD, and PPA
•• Refine the clinical, genetic, neuropsychological, radiologic, anRefine the clinical, genetic, neuropsychological, radiologic, and d pathologic characterization of the disorders that cause these pathologic characterization of the disorders that cause these disordersdisorders
•• Improve our understanding of tau and TDPImprove our understanding of tau and TDP--43 protein physiology 43 protein physiology and pathophysiology so promising therapies can be developed and and pathophysiology so promising therapies can be developed and testedtested
•• Identify and develop clinical, laboratory, neuropsychological, aIdentify and develop clinical, laboratory, neuropsychological, and nd radiologic measures for future therapeutic drug trialsradiologic measures for future therapeutic drug trials
Ultimately prevent, delay the onset, and slow the progression ofUltimately prevent, delay the onset, and slow the progression of the the
disorders that cause PSP, CBD, FTD, and PPAdisorders that cause PSP, CBD, FTD, and PPA
Resources
(some of many excellent resources)
ResourcesResources
(some of many excellent resources)(some of many excellent resources)
FTD and PPA Resources - Websites
FTD and PPA FTD and PPA Resources Resources -- WebsitesWebsites
http://www.ftdhttp://www.ftd--picks.orgpicks.org
http://www.brain.northwestern.edu/ppa/index.htmlhttp://www.brain.northwestern.edu/ppa/index.html
PSP and CBD Resources - Websites
PSP and CBD PSP and CBD Resources Resources -- WebsitesWebsites
http://www.ftdhttp://www.ftd--picks.orgpicks.org
http://curepsp.orghttp://curepsp.org
Questions?Questions?Questions?
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