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Slachevsky Chonchol, Andrea

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Slachevsky Chonchol

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Andrea María Slachevsky Conchol

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Item Type: Publication × Subject: Frontotemporal dementia ×

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    Allostatic-Interoceptive Overload in Frontotemporal Dementia
    (2022) Birba, Agustina; Santamaría-García, Hernando; Prado, Pavel; Cruzat, Josefina; Sainz Ballesteros , Agustín; Legaz , Agustina; Fittipaldi, Sol; Duran-Aniotz , Claudia; Slachevsky Chonchol, Andrea; Santibañez , Rodrigo; Sigman , Mariano; M. García , Adolfo; Whelan , Robert; Moguilner , Sebastián; Ibáñez , Agustín
    Background : The predictive coding theory of allostatic-interoceptive load states that brain networks mediating autonomic regulation and interoceptive-exteroceptive balance regulate the internal milieu to anticipate future needs and environmental demands. These functions seem to be distinctly compromised in behavioral variant frontotemporal dementia (bvFTD), including alterations of the allostatic-interoceptive network (AIN). Here, we hypothesize that bvFTD is typified by an allostatic-interoceptive overload. Methods : We assessed resting-state heartbeat evoked potential (rsHEP) modulation as well as its behavioral and multimodal neuroimaging correlates in patients with bvFTD relative to healthy control subjects and patients with Alzheimer’s disease (N = 94). We measured 1) resting-state electroencephalography (to assess the rsHEP, prompted by visceral inputs and modulated by internal body sensing), 2) associations between rsHEP and its neural generators (source location), 3) cognitive disturbances (cognitive state, executive functions, facial emotion recognition), 4) brain atrophy, and 5) resting-state functional magnetic resonance imaging functional connectivity (AIN vs. control networks). Results : Relative to healthy control subjects and patients with Alzheimer’s disease, patients with bvFTD presented more negative rsHEP amplitudes with sources in critical hubs of the AIN (insula, amygdala, somatosensory cortex, hippocampus, anterior cingulate cortex). This exacerbated rsHEP modulation selectively predicted the patients’ cognitive profile (including cognitive decline, executive dysfunction, and emotional impairments). In addition, increased rsHEP modulation in bvFTD was associated with decreased brain volume and connectivity of the AIN. Machine learning results confirmed AIN specificity in predicting the bvFTD group. Conclusions : Altogether, these results suggest that bvFTD may be characterized by an allostatic-interoceptive overload manifested in ongoing electrophysiological markers, brain atrophy, functional networks, and cognition.
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    Gaps in clinical research in frontotemporal dementia: A call for diversity and disparities-focused research
    (2023) Franzen, Sanne; Nuytemans, Karen; Bourdage, Renelle; Caramelli, Paulo; Ellajosyula, Ratnavalli; Finger, Elizabeth; Illán-Gala, Ignacio; Loi, Samantha M.; Morhardt, Darby; Pijnenburg, Yolande; Rascovsky, Katya; Williams, Monique M.; Yokoyama, Jennifer S.; Alladi, Suvarna; Ayhan, Yavuz; Broce, Iris; Castro-Suarez, Sheila; Coleman, Kristy; Cruz de Souza, Leonardo; Dacks, Penny A.; Boer, Sterr C. M. de; Leon, Jessica de; Dodge, Shana; Grasso, Stephanie; Gupta, Veer; Gupta, Vivek; Ghoshal, Nupur; Kamath, Vidyulata; Kumfor, Fiona; Matias-Guiu, Jordi A.; Narme, Pauline; Nielsen, Rune; Okhuevbie, Daniel; Piña-Escudero, Stefanie D.; Ruiz Garcia, Ramiro; Scarioni, Marta; Slachevsky Chonchol, Andrea; Suarez-Gonzalez, Aida; Lead Tee, Boon; Tsoy, Elena; Ulugut, Hülya; Babulal, Ganesh M.; Onyike, Chiadi U.
    Frontotemporal dementia (FTD) is one of the leading causes of dementia before age 65 and often manifests as abnormal behavior (in behavioral variant FTD) or language impairment (in primary progressive aphasia). FTD's exact clinical presentation varies by culture, language, education, social norms, and other socioeconomic factors; current research and clinical practice, however, is mainly based on studies conducted in North America and Western Europe. Changes in diagnostic criteria and procedures as well as new or adapted cognitive tests are likely needed to take into consideration global diversity. This perspective paper by two professional interest areas of the Alzheimer's Association International Society to Advance Alzheimer's Research and Treatment examines how increasing global diversity impacts the clinical presentation, screening, assessment, and diagnosis of FTD and its treatment and care. It subsequently provides recommendations to address immediate needs to advance global FTD research and clinical practice.

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