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Frontotemporal dementia. How to deal with its diagnostic complexity?
Annibale Antonioni, Emanuela Maria Raho, Enrico Granieri, Giacomo Koch. Expert Review of Neurotherapeutics, 2025-02-06
Topic: Risk, prevention and care in population studies
INTRODUCTION: Frontotemporal dementia (FTD) encompasses a group of heterogeneous neurodegenerative disorders. Aside from genetic cases, its diagnosis is challenging, particularly in the early stages when symptoms are ambiguous, and structural neuroimaging does not reveal characteristic patterns. AREAS COVERED: The authors performed a comprehensive literature search through MEDLINE, Scopus, and Web of Science databases to gather evidence to aid the diagnostic process for suspected FTD patients, particularly in early phases, even in sporadic cases, ranging from established to promising tools. Blood-based biomarkers might help identify very early neuropathological stages and guide further evaluations. Subsequently, neurophysiological measures reflecting functional changes in cortical excitatory/inhibitory circuits, along with functional neuroimaging assessing brain network, connectivity, metabolism, and perfusion alterations, could detect specific changes associated to FTD even decades before symptom onset. As the neuropathological process advances, cognitive-behavioral profiles and atrophy patterns emerge, distinguishing specific FTD subtypes. EXPERT OPINION: Emerging disease-modifying therapies require early patient enrollment. Therefore, a diagnostic paradigm shift is needed - from relying on typical cognitive and neuroimaging profiles of advanced cases to widely applicable biomarkers, primarily fluid biomarkers, and, subsequently, neurophysiological and functional neuroimaging biomarkers where appropriate. Additionally, exploring subjective complaints and behavioral changes detected by home-based technologies might be crucial for early diagnosis.
Key findings
- Subsequently, neurophysiological measures reflecting functional changes in cortical excitatory/inhibitory circuits, along with functional neuroimaging assessing brain network, connectivity, metabolism, and perfusion alterations, could detect specific changes associated to FTD even decades before symptom onset.
- As the neuropathological process advances, cognitive-behavioral profiles and atrophy patterns emerge, distinguishing specific FTD subtypes.
- EXPERT OPINION: Emerging disease-modifying therapies require early patient enrollment.
- Therefore, a diagnostic paradigm shift is needed - from relying on typical cognitive and neuroimaging profiles of advanced cases to widely applicable biomarkers, primarily fluid biomarkers, and, subsequently, neurophysiological and functional neuroimaging biomarkers where appropriate.
- Additionally, exploring subjective complaints and behavioral changes detected by home-based technologies might be crucial for early diagnosis.
Why it matters
This review discusses diagnostic tools for frontotemporal dementia, including blood-based biomarkers and functional neuroimaging, and notes that emerging disease-modifying therapies require early patient enrollment. It concerns frontotemporal dementia rather than Alzheimer's disease and reports no treatment, cure or prevention.
Study details
- Evidence strengthLow
How this study scored 43/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Expert Review of Neurotherapeutics) |
| Journal's citation record | 1 / 4 | Expert Review of Neurotherapeutics: journal h-index 125 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 3 / 7 | Cited 17 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 5.7 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 4 / 6 | Cited 10.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 2 other studies in this library |
| Still being cited | 2 / 4 | Cited 17 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Giacomo Koch: h-index 83 (OpenAlex, whole career) |
| Institution's track record | 0 / 3 | University of Ferrara: institution h-index 666 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 39911129) |
| Free to read | 2 / 2 | Free to read |
| Total | 43 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1080/14737175.2025.2461758
- PubMed: 39911129
- Original source →
- Free full text: Expert Review of Neurotherapeutics →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Antonioni, A., Raho, E. M., Granieri, E., & Koch, G. (2025). Frontotemporal dementia. How to deal with its diagnostic complexity? Expert Review of Neurotherapeutics. https://doi.org/10.1080/14737175.2025.2461758
Vancouver
Antonioni A, Raho EM, Granieri E, Koch G. Frontotemporal dementia. How to deal with its diagnostic complexity? Expert Review of Neurotherapeutics. 2025. doi:10.1080/14737175.2025.2461758. PMID: 39911129.
BibTeX
@article{antonioni2025-39911129,
author = {Antonioni, Annibale and Raho, Emanuela Maria and Granieri, Enrico and Koch, Giacomo},
title = {{Frontotemporal dementia. How to deal with its diagnostic complexity?}},
journal = {Expert Review of Neurotherapeutics},
year = {2025},
doi = {10.1080/14737175.2025.2461758},
pmid = {39911129},
url = {https://doi.org/10.1080/14737175.2025.2461758}
}
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