Fellowship project: Clinico-pathological correlations in FTD: a study in the Dutch population
During this one-year research fellowship granted by the European Academy of Neurology, I’ve had the great opportunity to carry on the collaboration with Alzheimer Centre and Pathology department at Amsterdam UMC, which I had previously started as a hosted Neurology Resident from Milan (Ospedale Maggiore Policlinico, Università degli Studi di Milano. Supervisors: Prof. E. Scarpini and Dr. D. Galimberti).
The aim of the project was to investigate and deeply characterize the relationships between the variegate clinical presentation and the complex pathology of Frontotemporal Dementia (FTD). This has been possible thanks to the efforts of the Netherlands Brain Bank and to the generosity of patients who have decided to donate their brains to scientific research.
Under the supervision of Dr. Yolande Pijnenburg (Alzheimer Centre), we studied the medical records of FTD brain donors from 2008 to 2017 at the symptom level, with a special focus on neuropsychiatric symptoms, which have recently been found to be part of the early clinical features of FTD.
With the help of co-supervisor Dr. Anke Dijkstra (Pathology Department), we characterized the brain pathology of the donors in detail, in light of the most recent neuropathological findings in the field of frontotemporal lobar degeneration (FTLD).
“We studied clinicopathological correlations in a large brain bank cohort of 150 donors and identified several early symptoms that can help to differentiate between underlying pathology. Hyperorality is the clinical feature that could best distinguish underlying FTLD from non-FTLD pathology. The presence of auditory hallucinations is associated with underlying FTLD-TDP pathology, and perseverative or compulsive behavior points to FTD-TDP type B or C histotypes” (Scarioni et al. Frontotemporal Dementia: Correlations Between Psychiatric Symptoms and Pathology. Annals of Neurology 2020;00:1–12).
I am happy that our research efforts have contributed to further understand a fascinating and complex disease such as FTD. My hope is that these results will help the inclusion of patients in future therapeutic trials. From my personal perspective, this research experience has been a wonderful learning opportunity: the daily work with world-renowned experts in the field of FTD challenged me to grow a lot as a neurologist and as a researcher. Also, working with so many other young colleagues has been stimulating and inspiring.