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GABA and glutamate deficits from frontotemporal lobar degeneration are associated with disinhibition.

Accepted version
Peer-reviewed

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Article

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Authors

Murley, Alexander G 
Rouse, Matthew A 
Jones, P Simon 
Hezemans, Frank H 

Abstract

Behavioural disinhibition is a common feature of the syndromes associated with frontotemporal lobar degeneration (FTLD). It is associated with high morbidity and lacks proven symptomatic treatments. A potential therapeutic strategy is to correct the neurotransmitter deficits associated with FTLD, thereby improving behaviour. Reductions in the neurotransmitters glutamate and GABA correlate with impulsive behaviour in several neuropsychiatric diseases and there is post-mortem evidence of their deficit in FTLD. Here, we tested the hypothesis that prefrontal glutamate and GABA levels are reduced by FTLD in vivo, and that their deficit is associated with impaired response inhibition. Thirty-three participants with a syndrome associated with FTLD (15 patients with behavioural variant frontotemporal dementia and 18 with progressive supranuclear palsy, including both Richardson's syndrome and progressive supranuclear palsy-frontal subtypes) and 20 healthy control subjects were included. Participants undertook ultra-high field (7 T) magnetic resonance spectroscopy and a stop-signal task of response inhibition. We measured glutamate and GABA levels using semi-LASER magnetic resonance spectroscopy in the right inferior frontal gyrus, because of its strong association with response inhibition, and in the primary visual cortex, as a control region. The stop-signal reaction time was calculated using an ex-Gaussian Bayesian model. Participants with frontotemporal dementia and progressive supranuclear palsy had impaired response inhibition, with longer stop-signal reaction times compared with controls. GABA concentration was reduced in patients versus controls in the right inferior frontal gyrus, but not the occipital lobe. There was no group-wise difference in partial volume corrected glutamate concentration between patients and controls. Both GABA and glutamate concentrations in the inferior frontal gyrus correlated inversely with stop-signal reaction time, indicating greater impulsivity in proportion to the loss of each neurotransmitter. We conclude that the glutamatergic and GABAergic deficits in the frontal lobe are potential targets for symptomatic drug treatment of frontotemporal dementia and progressive supranuclear palsy.

Description

Keywords

GABA, frontotemporal dementia, glutamate, impulsivity, progressive supranuclear palsy, Aged, Aged, 80 and over, Female, Frontotemporal Lobar Degeneration, Glutamates, Humans, Inhibition, Psychological, Magnetic Resonance Imaging, Magnetic Resonance Spectroscopy, Male, Middle Aged, Neuropsychological Tests, Neurotransmitter Agents, Reaction Time, Supranuclear Palsy, Progressive, Visual Cortex, gamma-Aminobutyric Acid

Journal Title

Brain

Conference Name

Journal ISSN

0006-8950
1460-2156

Volume Title

143

Publisher

Oxford University Press (OUP)

Rights

All rights reserved
Sponsorship
Wellcome Trust (103838/Z/14/Z)
Wellcome Trust (098436/Z/12/B)
Wellcome Trust (Unknown)
Cambridge University Hospitals NHS Foundation Trust (CUH) (146281)
(unknown)
Medical Research Council (MR/M008983/1)
Wellcome Trust (098436/Z/12/Z)
Biotechnology and Biological Sciences Research Council (BB/P021255/1)
Wellcome Trust (205067/Z/16/Z)
This work was funded by the Holt Fellowship (AGM), Wellcome Trust (JBR, 103838), a Sir Henry Dale Fellowship from the Wellcome Trust and the Royal Society (CTR, 098436/Z/12/B] the Cambridge Trust and Fitzwilliam College, Cambridge (FHH), the Medical Research Council (MR/M008983/1, SUAG/051 G101400), the National Institute for Health Research Cambridge Biomedical Research Centre and Cambridge Brain Bank (146281); and the Cambridge Centre for Parkinson Plus.