Biomarkers in frontotemporal dementia: Current landscape and future directions

Abstract

Frontotemporal dementia (FTD) is one of the most common neurodegenerative diseases, encompassing a myriad of different, clinically distinct subtypes which all target the frontoinsular region. FTD is characterized by a decline in behavioral, language, and executive functions. Due to its proximity to similar diseases, both in symptomology and mechanism, FTD remains challenging to diagnose conclusively. As a result, searching for distinct biomarkers that allow clinicians to differentiate between FTD and other neurocognitive disorders is extremely important. This review examines studies published in the past decade to evaluate which current biomarkers are the most clinically viable and where future research might lead. Genetic screening for FTD, specifically the three most common mutations to the TDP-43, MAPT, and PGRN genes, show promising predictive ability and could help patients access treatment in the early stages of the disease. In addition, serum and CSF biomarkers can help clinicians track the disease process and show good specificity when differentiating between FTD, primary psychiatric disorders, and other neurodegenerative diseases, especially when coupled with imaging techniques such as MRI and PET. Lastly, recent advances in machine learning may allow future researchers and clinicians to comprehensively analyze FTD's biochemical and imaging fingerprint, leading to increasingly accurate and timely diagnosis. Further work must be focused on transitioning the understanding of FTD biomarkers from research to concrete tools available to clinicians and patients, with the hopes of advancing the quality of care available to those suffering from FTD.