Nature versus Nurture in Frontotemporal Lobar Degeneration: the Interaction of Genetic Background and Education on Brain Damage.

Background: Frontotemporal lobar degeneration (FTLD is a progressive neurodegenerative disorder with a stron genetic background. It has been reported that modifiabl factors, i.e. education (E), might act as proxies for reserve capacity. Objective:To evaluate the impact of genetic background (positive family history, FH) on reserve mechanisms by measuring regional cerebral blood flow (rCBF) correlate in FTLD patients. Methods: 145 FTLD patients were recruited and underwent clinical, neuropsychological, behaviora assessment, and SPECT study. The main effect of E and FH on rCBF was evaluated. To test the potential interaction between the E and rCBF in FTLD patients with or withou positive FH, a difference of slope analysis in the two groups was calculated. All the analyses were controlled for disease severity (Clinical Dementia Rating Scale, FTD-CDR). Result A main effect of education (E+<E-) in frontal regions was reported, and high genetic loading (FH+<FH-) was associated with a greater bilateral temporoparietal hypoperfusion Evaluating the relationship between E and rCBF, a greater hypoperfusion of cingulate region in FH+ as compared to FH- was observed. Discussion: Reserve mechanisms are available also in presence of an unfavorable genetic status. However, these compensatory mechanisms are modulated by the interaction with genetic factors. [ABSTRACT FROM AUTHOR]