Research conducted through UCSF shows that smartphone-based cognitive tests are comparable to gold methods; may stumble upon FTD in gene carriers before symptoms appear.
A smartphone app could enable greater participation in clinical trials for others with frontotemporal dementia (FTD), a devastating neurological disorder that manifests in middle age.
Research on this disease has been hampered by disorders with early diagnosis and the difficulty of tracking how other people respond to remedies that are likely only effective in the early stages of the disease.
To address this issue, a study team led by UC San Francisco implemented cognitive tests in a mobile app and found that they could detect early FTD symptoms in other people who were genetically predisposed to the disease but had not yet developed symptoms. The tests were at least as delicate as the neuropsychological tests performed at the clinic.
Appears on JAMA Network Open on April 1, 2024.
More than 30 FTD clinical trials are underway or in the planning stages, with one that could be just the first drug approved to slow the progression of certain gene carriers. The researchers hope that the new generation of cells will speed up the work.
Over time, the app will be able to be used only to monitor treatment effects, replacing the maximum or maximum in-person visits to clinical trial sites. “
FTD is the leading cause of dementia in patients under the age of 60, and up to 30% of cases are attributed to genetics. There are three main variants with potentially overlapping symptoms. The most common reasons are dramatic personality changes, which can manifest as a lack of empathy, apathy, impulsivity, compulsive eating, and misplaced social and sexual behavior. Another affects movement and a third affects speech, language, and comprehension, which is the variant Bruce Willis is said to have. In rare cases, FTD unleashes bursts of visual creativity.
As with Alzheimer’s disease, FTD patients are thought to be more susceptible to treatment early on, preferably even before symptoms appear. “Most FTD patients are diagnosed relatively late because they are young and their symptoms are mistaken for psychiatric disorders. ” said senior author Adam Boxer, MD, PhD, professor of memory and aging in the UCSF Department of Neurology.
“We’ve heard from families who suspect their loved one has FTD long before the doctor accepts the diagnosis,” said Boxer, who is also director of the Alzheimer’s Disease and Frontotemporal Dementia Clinical Trials Program at UCSF.
The researchers followed 360 participants with an average age of 54 enrolled in ongoing studies at the ALLFTD and UCSF centers. Approximately 90% were aware of the level of the disease. Of those, 60% had FTD or had genes and had still developed symptoms. 20% had early symptoms of the disease and 21% had symptoms.
Staffaroni and Boxer collaborated with software company Datacubed Health, which evolved the platform to include tests of executive functions, such as scheduling and prioritization, distraction filtering, and impulse control. In FTD, the component of the brain responsible for executive functioning shrinks as the disease progresses.
The rich information gathered through the app, aggregating voice recordings and frame movements, has allowed researchers to expand new tests that could eventually aid in early diagnosis and symptom monitoring.
“We developed the ability to record speech while participants were doing other tests,” Staffaroni said. “We also created tests of walking, balance, and slow movements, as well as other facets of language. “
FTD researchers say they are on the verge of finding remedies that can eventually slow the progression of the disease, which is deadly. These come with gene and other therapies, such as antisense oligonucleotides (ASOs), to increase or minimize protein production in gene carriers.
While there are no plans to make the app available to the public lately, it can be a great aid to research.
“A major obstacle has been the lack of end-outcome measures that are easy to collect and sensitive to the effects of treatment in the early stages of the disease,” Staffaroni said. “We hope that smartphone evaluations will facilitate further trials of promising therapies. “
University of California – San Francisco
Staffaroni, A. M. et al. (2024). Reliability and Validity of Smartphone Cognitive Tests for Frontotemporal Lobe Degeneration. Open JAMA Network. is what je. org/10. 1001/jamanetworkopen. 2024. 4266.
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