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Long Loop Reflexes in Patients with Probable Alzheimer's Disease and Frontotemporal Dementia of Behavioral Type.

Abstract

Mane Mahesh Daryappa, Sadanandavalli Retnaswami Chandra, Srikala Bharath, Shantala Hegde, Mariamma Philip and Nitin Ramanujam C

Introduction: Dementia is a leading cause of morbidity in view of increasing expectation of life all over the world. With reference to Pharmacotherapy as well as non-pharmacological treatment options to be effective, diagnosis and therapy should be initiated very early. Currently, Diagnosis is made on clinical grounds and there is gross time delay. Therefore, there is serious need for cheap, easily accessible biomarker which improves diagnostic accuracy. The two common degenerative dementia's are AD and FTD. As AD is posterior, the frontal sub cortical circuits are preserved till late stage of disease as against in FTD. Using this rationale we tried to look for differential involvement of LLR2 in the above two conditions and controls.

Objective: There is serious need for cheap, easily accessible biomarker which improves diagnostic accuracy. The two common degenerative dementias are AD and FTD. As AD is posterior, the frontal sub cortical circuits are preserved till late stage of disease as against in FTD. Using this rationale we tried to look for differential involvement of LLR2 in the above two conditions and controls.

Patients and Methods: 20 patients diagnosed as mild to moderate probable AD, FTD, underwent all mandatory dementia work up including neuropsychological work up and LLR. 20 healthy controls were also evaluated with LLR. Data analysis was done using SPSS software licensed in department of biostatistics.

Observation: LLR was preserved in 70% of AD patients, 90% in normal controls and absent in all FTD patients.

Discussion: Currently, histopathology and genetics is the only tools for the diagnosis of definite types of degenerative dementia, which involves the problems of feasibility and availability. Absent LLR will be an additional biomarker in favor of FTD and presence of LLR will favor AD in mild to moderate cases of probable AD and FTD as per consensus criteria.

Conclusion: LLR 2 confirms as an additional biomarker in very early diagnosis of FTD and AD supporting our pilot study published previously.

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