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CC BY 4.0 · Arq Neuropsiquiatr 2023; 81(07): 632-640
DOI: 10.1055/s-0043-1771173
Original Article

Current clinical and research practices on frontotemporal dementia in Brazil: a national survey

Práticas clínicas e cenário de pesquisa em demência frontotemporal no Brasil: uma enquete nacional
Leonardo Cruz de Souza 
1   Universidade Federal de Minas Gerais, Departamento de Clínica Médica, Belo Horizonte MG, Brazil.
2   Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Clínica Médica, Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Belo Horizonte MG, Brazil.
,
Sonia Maria Dozzi Brucki 
3   Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, Grupo de Neurologia Cognitiva e do Comportamento, São Paulo SP, Brazil.
,
Lucas Porcello Schilling 
4   Pontifícia Universidade do Rio Grande do Sul, Escola de Medicina, Serviço de Neurologia, Porto Alegre RS, Brazil.
5   Pontifícia Universidade do Rio Grande do Sul, Instituto do Cérebro do Rio Grande do Sul, Porto Alegre RS, Brazil.
6   Pontifícia Universidade do Rio Grande do Sul, Programa de Pós-Graduação em Gerontologia Biomédica, Porto Alegre RS, Brazil.
,
Letícia Costa da Silva 
2   Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Clínica Médica, Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Belo Horizonte MG, Brazil.
,
Leonel Tadao Takada 
3   Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, Grupo de Neurologia Cognitiva e do Comportamento, São Paulo SP, Brazil.
,
Valéria Santoro Bahia 
7   Universidade Cidade de São Paulo, São Paulo SP, Brazil.
,
Breno José Alencar Pires Barbosa 
3   Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, Grupo de Neurologia Cognitiva e do Comportamento, São Paulo SP, Brazil.
8   Universidade Federal de Pernambuco, Centro de Ciências Médicas, Área Acadêmica de Neuropsiquiatria, Recife PE, Brazil.
,
Marcio Luiz Figueredo Balthazar 
9   Universidade Estadual de Campinas, Departamento de Neurologia, São Paulo SP, Brazil.
,
Norberto Anizio Ferreira Frota 
10   Hospital Geral de Fortaleza, Serviço de Neurologia, Fortaleza CE, Brazil.
11   Universidade de Fortaleza (UNIFOR), Fortaleza CE, Brazil.
,
Ricardo Nitrini 
3   Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, Grupo de Neurologia Cognitiva e do Comportamento, São Paulo SP, Brazil.
,
Paulo Caramelli 
1   Universidade Federal de Minas Gerais, Departamento de Clínica Médica, Belo Horizonte MG, Brazil.
2   Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Clínica Médica, Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Belo Horizonte MG, Brazil.
,
Jerusa Smid 
3   Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, Grupo de Neurologia Cognitiva e do Comportamento, São Paulo SP, Brazil.
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Support LCS and PC are supported by Brazilian National Council for Scientific and Technological Development (CNPq – bolsa de produtividade em pesquisa).
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Erratum zu diesem Artikel:

ErratumArq Neuropsiquiatr 2024; 82(02): e1-e1
DOI: 10.1055/s-0044-1779740

Abstract

Background Frontotemporal dementia (FTD) is a frequent cause of young-onset dementia and represents a major challenge for the diagnosis and clinical management. It is essential to evaluate the difficulties faced by physicians on the diagnostic workup and on patient care.

Objective The aim of this study was to investigate the current practices and the local limits on the diagnosis and management of FTD in Brazil.

Methods We elaborated an online survey, composed of 29 questions and divided in four parts, comprising questions about existing health facilities, clinical practices related to FTD, and suggestions to increment the national research on FTD. The invitation to participate was sent by email to all neurologists affiliated to the Brazilian Academy of Neurology (n = 3658), and to all physicians who attended the XII Meeting of Researchers on Alzheimer's disease, in 2019 (n = 187). The invitation was also diffused through social media.

Results 256 Brazilian physicians answered the questionnaire. The three most relevant disorders for the differential diagnosis of FTD were Alzheimer's disease (AD) (n = 211), bipolar disorder (n = 117) and dementia with Lewy bodies (n = 92). Most respondents (125/256) reported the difficulty in performing genetic testing as the main limit in the diagnostic of FTD. 93% and 63% of participants considered that the assessment of social cognition and AD CSF biomarkers are useful for the diagnosis of FTD, respectively.

Conclusions The present study may provide valuable insights for the medical education and clinical training of physicians, and to foster future research on FTD in Brazil.

Resumo

Antecedentes A demência frontotemporal (DFT) é causa frequente de demência pré-senil e representa um desafio em termos de diagnóstico e de manejo clínico. É essencial avaliar as dificuldades existentes na propedêutica e nos cuidados médicos.

Objetivo Investigar as práticas médicas e as dificuldades para diagnóstico e manejo da DFT no Brasil.

Métodos Elaborou-se um questionário online, composto de 29 questões, divididas em quatro partes, com perguntas sobre infraestrutura existente, práticas clínicas relacionadas à DFT e sugestões para desenvolver a pesquisa nacional na área. O convite para participação foi enviado por e-mail a todos neurologistas afiliados à Academia Brasileira de Neurologia (n = 3658), e aos médicos que participaram da XII Reunião de Pesquisadores de Doença de Alzheimer, em 2019 (n = 187). O convite também foi divulgado através de mídias sociais.

Resultados 256 médicos brasileiros responderam o questionário. Os três principais diagnósticos diferenciais de DFT foram doença de Alzheimer (n = 211), transtorno bipolar (n = 117) e demência com corpos de Lewy (n = 92). A maior parte dos respondedores (125/256) apontou a dificuldade em realizar testagem genética como o maior limite no diagnóstico de DFT. 93% e 63% dos respondedores indicaram que a avaliação de cognição social e o uso de biomarcadores liquóricos de doença de Alzheimer são úteis no diagnóstico de DFT, respectivamente.

Conclusões Estes resultados devem ser considerados na educação e treinamento médicos, e no desenvolvimento da pesquisa brasileira em DFT.

Keywords

Frontotemporal Dementia - Aging - Dementia

Palavras-chave

Demência Frontotemporal - Envelhecimento - Demência

Authors' Contributions

LCS: conceptualization, formal analysis, project administration, writing – original draft; SMDB, RN, PC: conceptualization, writing – review & editing; LPS, BJAPB: project administration, writing – review & editing; LCS: formal analysis, methodology, writing – review & editing; LT, VSB, MLFB, NAFF, JS: conceptualization, project administration, writing – review & editing.




Publikationsverlauf

Eingereicht: 15. Februar 2023

Angenommen: 03. April 2023

Artikel online veröffentlicht:
26. Juli 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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