%0 Journal Article %J J Alzheimers Dis %D 2023 %T Psychopharmacological Medication Use in Frontotemporal Dementia at the Time of Diagnosis: Comparison with Alzheimer's Disease. %A Katisko, Kasper %A Krüger, Johanna %A Soppela, Helmi %A Hartikainen, Päivi %A Haapasalo, Annakaisa %A Remes, Anne M %A Solje, Eino %K Alzheimer Disease %K Delayed Diagnosis %K Female %K Frontotemporal Dementia %K Humans %K Memantine %K Neurodegenerative Diseases %X

BACKGROUND: Due to the significant presence of neuropsychiatric symptoms in patients with frontotemporal dementia (FTD) spectrum disorders, psychiatric misdiagnoses, diagnostic delay, and use of psychiatric treatments are common prior to the FTD diagnosis. Furthermore, treatment of diagnosed FTD patients mainly relies on off-label psychopharmacological approaches. Currently, limited real-world data are available regarding the actual use of psychopharmacological medications in FTD.

OBJECTIVE: To evaluate psychopharmacological medication use at the time of FTD diagnosis.

METHODS: Psychopharmacological medication use was evaluated in a Finnish FTD cohort containing 222 FTD patients, including the major clinical disease phenotypes (behavioral, language, and motor variants) and genetic patients carrying the C9orf72 repeat expansion. A cohort of 214 Alzheimer's disease (AD) patients was used as a neurodegenerative disease reference group.

RESULTS: Active use of psychopharmacological medications at the time of diagnosis was significantly more common in FTD compared to AD, especially in the case of antidepressants (26.1% versus 15.0%, OR = 2.01, p = 0.008), antipsychotics (23.9% versus 9.3%, OR = 3.15, p < 0.001), and mood-stabilizers (6.3% versus 1.9%, OR = 2.93, p = 0.085; not statistically significant), whereas the use of cholinesterase inhibitors or memantine was nearly nonexistent in FTD patients. Female gender and behavioral variant of FTD phenotype alongside with depressive and psychotic symptoms were the most prominent factors associating with the use of these medications among the FTD spectrum patients.

CONCLUSION: Use of off-label psychopharmacological medication and polypharmacy is substantially common at the time of FTD diagnosis. This likely reflects the challenges in using symptom-driven treatment approaches, especially prior to the eventual diagnosis.

%B J Alzheimers Dis %V 95 %P 677-685 %8 2023 %G eng %N 2 %R 10.3233/JAD-230494 %0 Journal Article %J J Alzheimers Dis %D 2018 %T Low Prevalence of Cancer in Patients with Frontotemporal Lobar Degeneration. %A Katisko, Kasper %A Haapasalo, Annakaisa %A Koivisto, Anne %A Krüger, Johanna %A Hartikainen, Päivi %A Korhonen, Ville %A Helisalmi, Seppo %A Herukka, Sanna-Kaisa %A Remes, Anne M %A Solje, Eino %K Aged %K Alzheimer Disease %K C9orf72 Protein %K DNA Repeat Expansion %K Female %K Finland %K Frontotemporal Lobar Degeneration %K Heterozygote %K Humans %K Male %K Middle Aged %K Neoplasms %K Prevalence %X

Several studies have reported reduced risk of cancer in patients with Alzheimer's disease (AD) or Parkinson's disease. The relationship between cancer and frontotemporal lobar degeneration (FTLD) has not been previously reported. Here, our aim was to evaluate the occurrence of cancer in Finnish FTLD patients with a high proportion of C9ORF72 repeat expansion carriers in comparison to age- and sex-matched group of AD patients and control subjects classified as not cognitively impaired (NCI). The prevalence of cancer was 9.7% in FTLD, 18.7% in AD, and 17.4% in NCI (FTLD versus AD p = 0.012, FTLD versus NCI p = 0.029) groups. No differences were observed between C9ORF72 repeat expansion carriers and non-carriers inside the FTLD group. To our knowledge, this is the first study showing significantly lower prevalence of cancer in FTLD patients compared to patients with AD or NCI subjects. Our data suggest an inverse association between neurodegeneration and cancer and that FTLD-specific mechanisms may underlie the especially strong inverse association observed in this study.

%B J Alzheimers Dis %V 62 %P 789-794 %8 2018 %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/29480183?dopt=Abstract %R 10.3233/JAD-170854