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WEDNESDAY, May 1, 2019 (HealthDay News) — Progress has been made toward developing diagnostic criteria for limbic-predominant age-related TDP-43 encephalopathy (LATE), although gaps remain in understanding, according to a report published online April 30 in Brain<\/i>.<\/p>\n
Peter T. Nelson, M.D., Ph.D., from the University of Kentucky in Lexington, and colleagues describe LATE neuropathologic change (LATE-NC), which is defined by a stereotypical TDP-43 proteinopathy in older adults with or without coexisting hippocampal sclerosis pathology that mainly affects the oldest old. A working group was established to develop diagnostic criteria for LATE.<\/p>\n
The researchers report consensus-based recommendations, including guidelines for diagnosis and staging of LATE-NC. An anatomically based preliminary staging scheme was proposed for a routine autopsy workup of LATE-NC with TDP-43 immunohistochemistry on tissue from the amygdala, hippocampus, and middle frontal gyrus. The medial temporal lobe structures are preferentially affected by LATE-NC, but other areas are also impacted. Individuals with LATE-NC also had atrophy in the medial temporal lobes, frontal cortex, and other regions. Five genes with risk alleles for LATE-NC have been identified: GRN<\/i>, TMEM106B<\/i>, ABCC9<\/i>, KCNMB2<\/i>, and APOE<\/i>. These genetic risk variants indicate that LATE shares pathologic mechanisms with frontotemporal lobar degeneration and Alzheimer disease, with disease-specific underlying mechanisms. Gaps remain in the understanding of LATE, and there is an urgent need for more research.<\/p>\n
“It is hoped that these collective research efforts will one day result in successful preventative and therapeutic strategies,” the authors write.<\/p>\n