title: Systemic metabolism in frontotemporal dementia.
abstract: OBJECTIVE
  To document the metabolic changes in frontotemporal dementia, including serum cholesterol and insulin levels, and compare and contrast these changes to motor neuron disease, where metabolism is proposed to affect disease progression.
  
  
  METHODS
  A cohort of 90 patients with dementia (31 behavioral-variant frontotemporal dementia [bvFTD], 30 semantic dementia [SD], and 29 Alzheimer disease [AD]) underwent fasting blood cholesterol, glucose, and peripheral insulin level analysis. Insulin resistance was calculated using the homeostasis model assessment of insulin resistance (HOMA-IR). These results were compared with a cohort of 19 control subjects.
  
  
  RESULTS
  The bvFTD cohort had lower high-density lipoprotein (HDL) cholesterol levels compared with control and AD groups, and increased total cholesterol/HDL ratio and triglyceride levels compared with the control group. The SD cohort had increased triglyceride levels compared with control subjects. Both FTD groups had increased fasting insulin levels and HOMA-IR index compared with the control group, and this remained increased in the subjects with bvFTD compared to subjects with AD.
  
  
  CONCLUSIONS
  Both patients with bvFTD and those with SD have increased triglyceride and insulin levels and lower HDL cholesterol levels compared with controls, suggesting a state of peripheral insulin resistance. These factors have been found to affect prognosis in motor neuron disease favorably, although insulin resistance has been proposed as a mechanism promoting neurodegeneration. We discuss the potential role of metabolism in FTD pathophysiology and progression.
authors.affiliation: From Neuroscience Research Australia (R.M.A., M.M., L.B., G.M.H., M.C.K., J.R.H., O.P.), Sydney; Prince of Wales Clinical School (R.M.A., J.R.H.), School of Medical Sciences (G.M.H., O.P.), and ARC Centre of Excellence in Cognition and its Disorders (R.M.A., G.M.H., J.R.H., O.P.), the University of New South Wales, Sydney; and Sydney Medical School (M.C.K.), Brain and Mind Research Institute, University of Sydney, Australia.
authors.forename: Rebekah M
authors.initials: RM
authors.lastname: Ahmed
authors.affiliation: From Neuroscience Research Australia (R.M.A., M.M., L.B., G.M.H., M.C.K., J.R.H., O.P.), Sydney; Prince of Wales Clinical School (R.M.A., J.R.H.), School of Medical Sciences (G.M.H., O.P.), and ARC Centre of Excellence in Cognition and its Disorders (R.M.A., G.M.H., J.R.H., O.P.), the University of New South Wales, Sydney; and Sydney Medical School (M.C.K.), Brain and Mind Research Institute, University of Sydney, Australia.
authors.forename: Mia
authors.initials: M
authors.lastname: MacMillan
authors.affiliation: From Neuroscience Research Australia (R.M.A., M.M., L.B., G.M.H., M.C.K., J.R.H., O.P.), Sydney; Prince of Wales Clinical School (R.M.A., J.R.H.), School of Medical Sciences (G.M.H., O.P.), and ARC Centre of Excellence in Cognition and its Disorders (R.M.A., G.M.H., J.R.H., O.P.), the University of New South Wales, Sydney; and Sydney Medical School (M.C.K.), Brain and Mind Research Institute, University of Sydney, Australia.
authors.forename: Lauren
authors.initials: L
authors.lastname: Bartley
authors.affiliation: From Neuroscience Research Australia (R.M.A., M.M., L.B., G.M.H., M.C.K., J.R.H., O.P.), Sydney; Prince of Wales Clinical School (R.M.A., J.R.H.), School of Medical Sciences (G.M.H., O.P.), and ARC Centre of Excellence in Cognition and its Disorders (R.M.A., G.M.H., J.R.H., O.P.), the University of New South Wales, Sydney; and Sydney Medical School (M.C.K.), Brain and Mind Research Institute, University of Sydney, Australia.
authors.forename: Glenda M
authors.initials: GM
authors.lastname: Halliday
authors.affiliation: From Neuroscience Research Australia (R.M.A., M.M., L.B., G.M.H., M.C.K., J.R.H., O.P.), Sydney; Prince of Wales Clinical School (R.M.A., J.R.H.), School of Medical Sciences (G.M.H., O.P.), and ARC Centre of Excellence in Cognition and its Disorders (R.M.A., G.M.H., J.R.H., O.P.), the University of New South Wales, Sydney; and Sydney Medical School (M.C.K.), Brain and Mind Research Institute, University of Sydney, Australia.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Kiernan
authors.affiliation: From Neuroscience Research Australia (R.M.A., M.M., L.B., G.M.H., M.C.K., J.R.H., O.P.), Sydney; Prince of Wales Clinical School (R.M.A., J.R.H.), School of Medical Sciences (G.M.H., O.P.), and ARC Centre of Excellence in Cognition and its Disorders (R.M.A., G.M.H., J.R.H., O.P.), the University of New South Wales, Sydney; and Sydney Medical School (M.C.K.), Brain and Mind Research Institute, University of Sydney, Australia.
authors.forename: John R
authors.initials: JR
authors.lastname: Hodges
authors.affiliation: From Neuroscience Research Australia (R.M.A., M.M., L.B., G.M.H., M.C.K., J.R.H., O.P.), Sydney; Prince of Wales Clinical School (R.M.A., J.R.H.), School of Medical Sciences (G.M.H., O.P.), and ARC Centre of Excellence in Cognition and its Disorders (R.M.A., G.M.H., J.R.H., O.P.), the University of New South Wales, Sydney; and Sydney Medical School (M.C.K.), Brain and Mind Research Institute, University of Sydney, Australia. o.piguet@neura.edu.au.
authors.forename: Olivier
authors.initials: O
authors.lastname: Piguet
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000150:complications / Q000378:metabolism; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D015331:Cohort Studies; D005215:Fasting / Q000097:blood; D005247:Feeding Behavior / Q000502:physiology; D005260:Female; D057180:Frontotemporal Dementia / Q000097:blood* / Q000150:complications* / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology; D008297:Male; D008659:Metabolic Diseases / Q000097:blood* / Q000209:etiology*; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires; D014280:Triglycerides / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D007328:Insulin; D014280:Triglycerides; D002784:Cholesterol