# Project 4: Precision Medicine and bvFTD Diagnosis

> **NIH NIH P01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2022 · $183,769

## Abstract

ABSTRACT
The overarching goal of this project is to further improve the differential diagnosis of bvFTD and its underlying
neuropathologies in the individual patient, addressing practical limitations to diagnosis both in the clinic and in
clinical research settings. Despite substantial advances over the last decades in the clinical and bench
science of bvFTD, there are still impediments to progress in this area. First, though in a research setting we
have become expert at differentiating bvFTD from various amnestic and non-amnestic variants of AD, bvFTD
and AD are still routinely mistaken for each other in both primary and tertiary care centers, demonstrating that
community providers still need practical, clinically realistic approaches to differentiating bvFTD and AD. To this
end, we will develop a brief, targeted clinical evaluation that is sensitive and specific for the clinical diagnosis of
bvFTD versus AD. Second, identification of the molecule responsible for the bvFTD syndrome in an individual
patient -- tau, TDP43, or FUS – remains challenging, even in a research environment where advanced
diagnostic tools are available. Thus we will study novel biomarkers such as tau imaging, CSF biomarkers, DNA
polymorphisms and RNA expression patterns for their value for in-vivo separation of the bvFTD molecular
subtypes. Finally, in both community settings and expert FTD centers, bvFTD and primary mood disorders
(MD) such as major depressive disorder (MDD) and bipolar affective disorder (BD) are frequently mistaken for
each other. Direct comparison is needed to guide their differentiation, thus we will systematically examine
groups of MDD and BD patients with a comprehensive set of neurologic measures and compare them to our
bvFTD patients. This will also be an opportunity to explore the clinical presentations of the subset of MD
patients in whom biomarkers of neurodegeneration are found. To accomplish our goals, we propose the
following aims and activities: AIM 1: Identify a set of measures that can discriminate bvFTD from AD at a high
level of accuracy and combine them into a brief clinical assessment protocol that could realistically be adopted
in clinic. The clinical, imaging, and laboratory data collected in the previous 14 years of this PPG will be
analyzed and a standardized clinical battery will be developed that is sensitive to the diagnosis of bvFTD and
to the separation of bvFTD from AD and from healthy older controls. Over the next four years this battery will
be validated prospectively, using a tiered approach to model cut-points where shifts in sensitivity/specificity
occur with the addition of specific clinical tests that incur additional financial and time costs. AIM 2: We will
examine the benefit of more recently developed biomarker approaches to diagnosis in our bvFTD patients to
determine which measures best segregate the molecular subtypes of bvFTD. AIM 3: Comprehensively
evaluate patients with MD (MDD and BD), matched by age (40-7...

## Key facts

- **NIH application ID:** 10684510
- **Project number:** 3P01AG019724-20S3
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** BRUCE L MILLER
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $183,769
- **Award type:** 3
- **Project period:** 2002-09-01 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10684510

## Citation

> US National Institutes of Health, RePORTER application 10684510, Project 4: Precision Medicine and bvFTD Diagnosis (3P01AG019724-20S3). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10684510. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*