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Limbic-predominant Age-related TDP-43 Encephalopathy (LATE): A common pathology of the oldest old
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Credit
CE:1.5
Description
Limbic-predominant Age-related TDP-43 Encephalopathy (LATE): A common pathology of the oldest old
This course will introduce the recently defined “Limbic-predominant Age-related TDP-43 Encephalopathy (LATE)” including both the clinical and neuropathologic manifestations. The course will begin with some historical perspective on TDP-43 as a pathologic protein in neurodegenerative disease, starting with its initial association with frontotemporal lobar degeneration (FTLD) and motor neuron disease (MND) and culminating with the recent studies describing its pervasiveness in the brains of the oldest-old and its intersection with Alzheimer’s disease (AD). The pathology and diagnostic approach will be described and compared with that of FTLD and MND, particularly focusing on the debate as to whether LATE is a distinct entity or on a continuum with these other TDP-43 proteinopathies. Finally, we will discuss the clinical consequences of LATE, including the clinicopathologic correlation, the potential impact on diagnosis and patient management, and the effects on research efforts to understand AD pathophysiology, particularly genetic studies (GWAS) and clinical trials.
This course will introduce the recently defined “Limbic-predominant Age-related TDP-43 Encephalopathy (LATE)” including both the clinical and neuropathologic manifestations. The course will begin with some historical perspective on TDP-43 as a pathologic protein in neurodegenerative disease, starting with its initial association with frontotemporal lobar degeneration (FTLD) and motor neuron disease (MND) and culminating with the recent studies describing its pervasiveness in the brains of the oldest-old and its intersection with Alzheimer’s disease (AD). The pathology and diagnostic approach will be described and compared with that of FTLD and MND, particularly focusing on the debate as to whether LATE is a distinct entity or on a continuum with these other TDP-43 proteinopathies. Finally, we will discuss the clinical consequences of LATE, including the clinicopathologic correlation, the potential impact on diagnosis and patient management, and the effects on research efforts to understand AD pathophysiology, particularly genetic studies (GWAS) and clinical trials.
Learning Objectives
1. Compare the brain regions most commonly affected in LATE, FTLD, and MND and explain the clinical similarities and differences between these three entities.
2. Recognize the clinical associations of LATE and describe the clinical overlap with AD.
3. Discuss the challenges in making a diagnosis of LATE and the potential consequences for both treatment and research in neurodegenerative disease.
Target Audience: Individuals who interact with patient’s presenting with cognitive decline and dementia and are members of the care team involved in making a diagnosis to explain the patient’s symptoms.
Instructional Level: Intermediate - Assumes a basic understanding of dementia syndromes but a very limited understanding of the underlying neuropathology.