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Pharmacotherapy for Neuropsychiatric Symptoms in Frontotemporal Dementia

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Abstract

Despite significant progress in the understanding of the frontotemporal dementias (FTDs), there remains no disease-modifying treatment for these conditions, and limited effective symptomatic treatment. Behavioural variant frontotemporal dementia (bvFTD) is the most common FTD syndrome, and is characterized by severe impairments in behaviour, personality and cognition. Neuropsychiatric symptoms are common features of bvFTD but are present in the other FTD syndromes. Current treatment strategies therefore focus on ameliorating the neuropsychiatric features. Here we review the rationale for current treatments related to each of the main neuropsychiatric symptoms forming the diagnostic criteria for bvFTD relevant to all FTD subtypes, and two additional symptoms not currently part of the diagnostic criteria: lack of insight and psychosis. Given the paucity of effective treatments for these symptoms, we highlight how contributing mechanisms delineated in cognitive neuroscience may inform future approaches to clinical trials and more precise symptomatic treatments for FTDs.

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    Christine Le & Elizabeth Finger

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Physician Services Incorporated Foundation Clinical Research Award to Dr E. Finger, and CIHR grant #363926.

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Dr Le has no conflicts to report. Dr Finger has received personal compensation for serving on a Scientific Advisory Committee for Biogen, Vigil Neuro, and Denali Therapeutics, for serving as a section editor for NeuroImage Clinical, and for serving as a course director for the AAN Annual Meeting. Dr Finger has received research support paid to her institution (UWO) from CIHR and the Weston Foundation to conduct an ongoing study of oxytocin in FTD, from Alzheimer Society of Canada, and the Physicians and Services Incorporated Foundation, the Ministry of Research and Innovation of Ontario for research, and for site participation in clinical trials sponsored by Alector, Biogen, and TauRx.

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Le, C., Finger, E. Pharmacotherapy for Neuropsychiatric Symptoms in Frontotemporal Dementia. CNS Drugs 35, 1081–1096 (2021). https://doi.org/10.1007/s40263-021-00854-5

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