According to a recent study published in Alzheimer’s & Dementia: Translational Research & Clinical Interventions, a condition with symptoms identical to those of behavioral variant frontotemporal degeneration (bvFTD) can be identified by finding a cerebrospinal fluid (CSF) leak using a specific kind of medical imaging, then reduced using a surgical procedure to fix the leak.

CSF surrounds the brain and spinal cord to act as a “shock absorber” for the delicate organs, as well as help the brain remain buoyant and upright in the skull. CSF also helps provide nutrients for the brain. When this fluid leaks, it can cause the brain to sag, which can cause the onset of symptoms familiar to bvFTD, such as personality changes, apathy, and socially inappropriate behavior.

Brain sagging is visible on a typical MRI scan, while a CSF leak in the membrane that typically contains the fluid to the brain and spine can be detected using a CT scan. However, CSF leaks from the spine into a vein are invisible on a CT scan.

The authors of the study discovered that a vein-based CSF leak can be detected using a special type of CT scan called a “digital subtraction myelogram.” The procedure involves the injection of a tracer compound that will make the leak visible when scanned. Once the leak is identified, the authors found that a surgical procedure to seal the leak can help reverse bvFTD-like symptoms by alleviating brain sagging.

Nine of the 21 participants in the study had a detectable CSF leak. After receiving surgery to fix CSF leakage, all nine participants saw their symptoms begin to ease. Of the remaining participants who did not have a detectable leak, only three saw their symptoms improve when they received alternative interventions such as CSF injections to the spine.

“Great efforts need to be made to improve the detection rate of CSF leak in these patients,” Dr. Wouter Schievink, one of the study’s authors, told Medical News Today. “We have developed non-targeted treatments for patients where no leak can be detected, but as our study shows, these treatments are much less effective than targeted, surgical correction of the leak.”

While the study does not provide a treatment for bvFTD itself, it achieves an important milestone in helping physicians differentiate bvFTD from other disorders with similar or even identical symptoms. Being able to definitively rule out CSF leakage as a cause can help hasten the process of identifying the cause of FTD-like symptoms, and reduce the time to a proper diagnosis.

Interested in reading more about research on FTD? Click here to read an article about a study analyzing use of TDP-43 levels in blood serum samples as a potential biomarker, or click here to read an article about a study examining the use of CSF biomarkers to diagnose FTD.