A volunteer from Alzheimer Bulgaria Association presented her scientific work at ISFTD’s conference in Lille

The International Society for Frontotemporal Dementias is a non-profit scientific society focused on frontotemporal dementias. Members include the leaders in frontotemporal dementia research around the world, and the society is associated with a large, international biannual meeting presenting the latest findings.

Between the 2nd and 5th of November this year, the International Society for Frontotemporal Dementias held one of its annual meetings in France – a country with a long tradition in the field of research dedicated to dementia diseases. After Sydney, Munich and Vancouver, the congress took place in the lovely city of Lille and gathered in one place representatives from dozens of countries on five continents from some of the world’s most prestigious academic institutions and consortia of experts, doctors, and scientists. 

Frontotemporal dementia is the second most common cause of dementia in people younger than 65 years of age, and presents with a complex clinical picture including language, motor and cognitive impairments, as well as behavioural and personality changes. The disease, similarly to Alzheimer’s disease, has a familial (inherited) and sporadic form, with genetic predisposition contributing to nearly 30 % of frontotemporal dementia cases. Over the past 20 years, significant progress has been made in understanding the molecular and genetic basis of the condition, identifying lifestyle-related environmental risk factors that interact with the genetic risk, and developing therapeutic approaches.

It was these questions that were among the many exciting topics that experts and scientists discussed during the congress in Lille. Some of the key themes included the discovery of new candidate biomarkers signaling the onset and progression of the disease, such as the accumulation of protein fragments of tau and TDP-43 in the brain, changes in neurofilament light chains (NFL), a class of intermediate filaments that help neuronal cells to maintain their stability and growth, and chronic brain inflammation. In addition, the experts discussed the discovery of new genes that are involved in causing frontotemporal dementia, as well as other conditions under the broader spectrum of frontotemporal lobar degeneration, such as progressive supranuclear palsy and amyotrophic lateral sclerosis. Professionals from leading world universities also commented on the progress in our understanding of some of the symptoms accompanying the complex clinical picture of frontotemporal dementia, such as hallucinations, depression, aggression, indifference and lack of empathy, which are also manifested in other psychiatric diseases.

One of the special aspects of the congress in Lille, apart from its scale as a forum for collaboration and discussion of the most outstanding scientific discoveries, is its combination with Caregivers Day, which takes place simultaneously with the congress. The Caregivers Day focuses entirely on lectures, seminars and presentations specifically aimed at families and carers of people with frontotemporal dementia. Some of the topics covered during this day were recent scientific and technological developments that can help reduce some of the burden on carers. There was also a creative workshop where caregivers could share their experiences and feelings and were invited to engage in a dialogue about the disease alongside the researchers.

We are particularly proud that our volunteer from the “Training and Coordination” team, Ivana Kancheva, was one of the investigators invited to present their work with a poster presentation. Ivana is pursuing a Master’s degree in Cognitive Neuroscience at Utrecht University, but during the congress she presented a project she is working on as an intern at the University of Cambridge under the supervision of Doctor Kamen Tsvetanov. Ivana is one of the volunteers who are especially passionate about Alzheimer Bulgaria’s mission to open a dialogue dedicated to the prevention of neurodegenerative diseases through a healthy lifestyle, and it is this passion that accidentally led her to meet Dr. Tsvetanov, who is a Senior Research Fellow in the Department of Clinical Neurosciences at Cambridge, and a researcher with many years of experience in the field of brain and cognitive ageing. Their joint work is concentrated on a similarly interesting topic with important social implications – the influence of cerebrovascular changes in the trajectory of pathological changes causing frontotemporal dementia and underlying its development and deterioration with age.

Specifically, the project examines cerebrovascular reactivity, which denotes the ability of cerebral blood vessels to dynamically regulate blood supply to the brain and is an indicator of good brain health. The process can be measured safely, reliably, and at large scale using the resting-state fluctuation amplitudes, a signal that can be extracted through certain pre-processing steps from functional magnetic resonance imaging (fMRI) data. Ivana and Kamen observed a decrease in cerebrovascular reactivity in patients who developed frontotemporal dementia, but more interestingly, these changes in key regions of the brain that support higher-order cognitive processes occur even in the pre-symptomatic stage and are associated with cognitive decline.

These results highlight the importance of maintaining good cardiovascular and, consequently, cerebrovascular health, in people with a genetic risk for developing frontotemporal dementia, as well as any other form of dementia and neurodegenerative disease. Good cardiovascular and cerebrovascular health depends on an active lifestyle, blood pressure control, and regulation of the levels of the so-called “bad” LDL (low-density lipoproteins) cholesterol and triglyceride levels. Low-density lipoproteins can be deposited in the walls of arteries and tissues, forming atherosclerotic plaques. When people smoke or have a poor diet, for example, LDL gets oxidized, which causes and maintains inflammatory processes in the body, accelerates the stiffening and narrowing of the arteries, and makes it difficult for them to dilate normally, which is necessary for physical activity, for instance. The end result is impaired oxygen delivery – reduced blood supply (ischemia) to the brain, which increases the risk of stroke, dementia, and cerebrovascular disease, as well as cognitive decline in old age.

Ivana and Kamen hope that this type of research will gain popularity in Bulgaria as well, giving hope to people with an increased risk of developing dementia, that by improving their lifestyle, they can delay the onset of dementia symptoms and even prevent it.

You can read more about the conference and the exciting topics presented in Lille on the official website of the International Society for Frontotemporal Dementias: HERE