Frontotemporal dementia

Frontotemporal dementia

In Context and adipose tissues (Rice and Safford) as formidable donor cells for transplant therapy in stroke are discussed. Next, the authors recognis...

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In Context

and adipose tissues (Rice and Safford) as formidable donor cells for transplant therapy in stroke are discussed. Next, the authors recognise the need to understand the mechanisms that underlie the therapeutic benefits of cell therapy in stroke, and propose cellular pathways as either graft-derived or host-derived, respectively (Chapters 5 and 7). The authors of both chapters, however, strongly opine that a cross-talk between the grafts and the host is a key cellular process that mediates functional recovery in stroke. Equally, if not more devastating than ischaemic stroke, intracerebral hemorrhage (ICH) is also a candidate for cell therapy. In Chapter 6, Chu, Jung, and Roh argue the relevance of ICH pathophysiology to stroke, thereby suggesting that cell transplantation is indicated for this disease, but concur in the end that much additional laboratory work is needed to fully assess the benefits of cell therapy in ICH. The authors rightfully acknowledge the importance of ethical concerns in cell therapy when clinical trials are designed. In Chapter 8, Macklin informs us on the current status of regulating cell research and its clinical applications, not

only with reference to the US and European legislation, but also tackling the sentiments gained from public scrutiny. Notwithstanding that the general consensus of the preceding chapters is upbeat about the milestone achievements of cell therapy for stroke, Savitz and Caplan remind us in the concluding chapter that the battle to translate the laboratory findings into the clinic has just begun, and highlight the hetereogenous features of stroke that necessitate careful patient selection criteria; consequently, the timing, delivery, and route of cell transplantation remain to be optimised. The contributors to this book give an unbiased evaluation of cell therapy in stroke and contemplate the breakthroughs and the blunders the field has encountered in the past; they also outline the building blocks needed to carry regenerative medicine towards a safe and efficacious clinical application.

Cesar V Borlongan [email protected]

Frontotemporal dementia Although no book can completely capture the rapid revolutions in the field of frontotemporal dementia (FTD), Frontotemporal Dementia Syndromes certainly does a great job in summarising some of these advances, and serves as an excellent treatise on these disorders for all professionals with an interest in neurodegenerative disorders. This is the third in a series of authoritative books on FTD from Cambridge University Press, and it relies heavily on, but is not limited to, its own researchers’ results, drawn from 300 patients who were followed up clinically and more than 100 brains studied with molecular pathology techniques. The introductory chapter is a historical account of FTD, starting with its original description by Arnold Pick in the 1890s, and the slow evolution of the nomenclature to keep pace with advances in knowledge. Moving through the complex epidemiology of FTD in the second chapter, the reader rapidly comes to the three core clinical variants of FTD syndromes—the frontobehavioural variant, semantic dementia, and progressive non-fluent aphasia—which are appropriately dealt with in the third chapter, with comparative tables and informative boxes. Although appropriate distinctions are drawn with Alzheimer’s disease and psychiatric disorders, the clinicopathological commonalities and overlaps of these variants within themselves or with other neurodegenerative disorders are also emphasised. How FTD fits into the clinical spectrum of other progressive neurodegenerative cortical and extrapyramidal disorders is discussed in the next chapter, thus supporting the view that FTD is a continuum disorder. Structural and functional neuroimaging, histopathological www.thelancet.com/neurology Vol 7 August 2008

and molecular neuropathology, and molecular genetics are discussed in the next four chapters, and an appropriate importance has been allocated to these fields. Although the section on molecular neuropathology mostly deals with FTD-tau, the chapter also discusses the more common non-tau forms and the identification of TDP-43 pathology in patients with ubiquitin-positive inclusions or amyotrophic lateral sclerosis. In the chapter on FTD genetics, the identification of the progranulin gene is discussed as a main cause of ubiquitin-positive inclusions, with fresh estimates on the relative frequencies of different genes that are linked to FTD. The focus is mainly on the association between genetics and the clinical and neuropathological characteristics of FTD and related genetic neurodegenerative disorders. A particular merit is that the most recent findings were included during the finalisation stages of the book. The final chapter covers the management of patients and also offers case-study material that caregivers would find useful. Despite being multiauthored, and with the occasional typo, different chapters are sewn together well. If the field continues to progress at the pace it is now, the FTD criteria and distinctions with other neurodegenerative diseases will change. In the meantime, Frontotemporal Dementia Syndromes will, without doubt, become one of the standard textbooks on FTD syndromes.

Frontotemporal Dementia Syndromes Edited by John R Hodges. Cambridge University Press, 2008. Pp 346. $110. ISBN 97-0-52185-477-1

Samir Kumar-Singh, Marc Cruts [email protected]; [email protected]

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