Semantic dementia

disease
On this page

Also known as dementia, frontotemporaldementia, frontotemporal, with or without parkinsonismfrontotemporal dementiaFTDsemantic primary progressive aphasiasemantic variant PPA

Summary

Semantic dementia (MONDO:0010857) is a disease caused by variants in MAPT and PSEN1, with 2 cohort genes and 161 clinical trials. Top therapeutic interventions include citalopram, florbetapir, and memantine.

At a glance

  • Prevalence: <1 / 1 000 000 (Worldwide) [Orphanet-validated]
  • Causal genes: MAPT (GenCC Strong), PSEN1 (GenCC Strong)
  • Cohort genes: 2
  • ClinVar variants: 1
  • Phenotypes (HPO): 10
  • Clinical trials: 161

Clinical features

Epidemiology

Prevalence records

2 prevalence record(s), Orphanet:

TypeClassValueGeographyValidation
Cases/families49WorldwideValidated
Point prevalence<1 / 1 000 000WorldwideValidated

Signs & symptoms

Clinical features (HPO)

10 HPO clinical features (Orphanet curated; top 10 by frequency):

HPO IDTermFrequency
HP:0002381AphasiaVery frequent (80-99%)
HP:0012444Brain atrophyVery frequent (80-99%)
HP:0030222Visual agnosiaVery frequent (80-99%)
HP:0030784AnomiaVery frequent (80-99%)
HP:0000726DementiaFrequent (30-79%)
HP:0002167Abnormality of speech or vocalizationFrequent (30-79%)
HP:0010522DyslexiaFrequent (30-79%)
HP:0010523AlexiaFrequent (30-79%)
HP:0010526DysgraphiaFrequent (30-79%)
HP:0012671AbuliaFrequent (30-79%)

Identifiers

Disease identifiers

FieldValue
Canonical namesemantic dementia
Mondo IDMONDO:0010857
OMIM600274
Orphanet100069
DOIDDOID:0051060, DOID:0081391
UMLSC0338462
MedGen83268
GARD0010792
Is cancer (heuristic)no

Also known as: dementia, frontotemporal · dementia, frontotemporal, with or without parkinsonism · frontotemporal dementia · FTD · semantic primary progressive aphasia · semantic variant PPA

Data availability: 1 ClinVar variant · 3 GenCC gene-disease records · 143 cell lines.

Disease family

An umbrella term covering 1 Mondo subtype.

Classification path: disease › human disease › disease by body system or component › nervous system disordermovement disorderprogressive non-fluent aphasiasemantic dementia

Subtypes (1): frontotemporal dementia, right temporal atrophy variant

Genetics & variants

GWAS landscape

No GWAS associations recorded — common-variant (GWAS) studies don’t cover this disease (typical for Mendelian / rare diseases). See the curated gene cohort and Mendelian overlap below.

Variant details and genetic-evidence tiers

ClinVar germline variants

1 retrieved; paginated sample, class counts are floors:

1 conflicting classifications of pathogenicity

ClinVarVariant (HGVS)GeneClassificationReview
3036349NM_001377265.1(MAPT):c.1568G>A (p.Arg523Gln)MAPTConflicting classifications of pathogenicitycriteria provided, conflicting classifications

Genes & proteins

Mendelian disease overlap and somatic drivers

GenCC: 20 · Orphanet: 13 · OMIM-shared: 0 · Dual-evidence (GWAS+Mendelian): 0

GenCC gene–disease validity (cohort genes)

the Disease column is the GenCC-asserted condition — a cohort gene’s strongest validity may be for a related predisposition syndrome.

GeneClassificationInheritanceDiseaseRecords
MAPTStrongAutosomal dominantsemantic dementia8
PSEN1StrongAutosomal dominantsemantic dementia12

Orphanet rare-disease linkage (cohort genes)

GeneOrphanet IDRare disease
MAPTOrphanet:100069Semantic dementia
MAPTOrphanet:100070Progressive non-fluent aphasia
MAPTOrphanet:240071Classic progressive supranuclear palsy syndrome
MAPTOrphanet:240085Progressive supranuclear palsy-predominant parkinsonism syndrome
MAPTOrphanet:240094Progressive supranuclear palsy-pure akinesia with gait freezing syndrome
MAPTOrphanet:240103Progressive supranuclear palsy-corticobasal syndrome
MAPTOrphanet:240112Progressive supranuclear palsy-progressive non-fluent aphasia syndrome
MAPTOrphanet:275864Behavioral variant of frontotemporal dementia
PSEN1Orphanet:100069Semantic dementia
PSEN1Orphanet:100070Progressive non-fluent aphasia
PSEN1Orphanet:1020Early-onset autosomal dominant Alzheimer disease
PSEN1Orphanet:154Familial isolated dilated cardiomyopathy
PSEN1Orphanet:275864Behavioral variant of frontotemporal dementia

Cohort genes → proteins

2 cohort genes, 2 distinct canonical proteins.

Evidence partition

SubsetGenes
multi_evidence2

Cohort genes (full)

SymbolHGNCEnsemblUniProtNameEvidence
MAPTHGNC:6893ENSG00000186868P10636Microtubule-associated protein taugencc,clinvar
PSEN1HGNC:9508ENSG00000080815P49768Presenilin-1gencc

Cohort function summary

Lead sentence per gene, UniProt-curated.

SymbolProtein nameFunction (lead sentence)
MAPTMicrotubule-associated protein tauPromotes microtubule assembly and stability, and might be involved in the establishment and maintenance of neuronal polarity.
PSEN1Presenilin-1Catalytic subunit of the gamma-secretase complex, an endoprotease complex that catalyzes the intramembrane cleavage of integral membrane proteins such as Notch receptors and APP (amyloid-beta precursor protein).

Protein-family classification

Druggable: 1 · Difficult: 0 · Unknown: 1 · Druggable fraction: 0.5

Family distribution

Cohort families vs a genome-wide background (hypergeometric, BH-FDR; fold = observed/expected). Counts kept; sorted by enrichment, so the catch-all Other/Unknown bucket no longer leads.

FamilyGenesFoldFDR
Protease118.3×0.108
Other/Unknown10.9×0.805

Per-gene assignment

SymbolFamilyDruggable?ECInterPro (top 3)
MAPTOther/UnknownnoMAP_tubulin-bd_rpt, Tau, MAP2/MAP4/Tau
PSEN1ProteaseyesPeptidase_A22A, Pept_A22A_PS1, Preselin/SPP

Expression context

Cohort genes with no expression data: 0.

2 cohort genes are a single-cell marker in ≥1 SCXA experiment.

Breadth distribution (Bgee present_calls)

BucketGenes
narrow (1-5 tissues)0
moderate (6-20)0
broad (>20)2
unknown0

Top tissues across cohort

TissueCohort genes
cortical plate1
prefrontal cortex1
superior frontal gyrus1
C1 segment of cervical spinal cord1
corpus callosum1
middle frontal gyrus1

Per-gene tissue summary (top 30)

SymbolBgee breadthFANTOM5 breadthSCXATop tissues
MAPT141broadmarkercortical plate, superior frontal gyrus, prefrontal cortex
PSEN1287ubiquitousmarkermiddle frontal gyrus, corpus callosum, C1 segment of cervical spinal cord

Protein interactions among cohort

Intra-cohort edges: 1.

Hub genes (top 10 by interactor count)

SymbolInteractor count
MAPT7,289
PSEN13,732

Intra-cohort edges

ABSources
MAPTPSEN1string_interaction

Structural data

PDB: 2 · AlphaFold-only: 0 · No structure: 0

Cohort genes with PDB structures (top 30)

SymbolUniProtPDB entries
MAPTP10636293
PSEN1P4976827

Function

Pathway analysis

Distinct Reactome pathways touched by cohort: 21. Enrichment computed across 2 evidence-associated genes (2 with Reactome annotation).

Pathways by enrichment

Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 2 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

PathwayCohort genesFoldFDRSample cohort genes
Noncanonical activation of NOTCH31713.8×0.009PSEN1
Regulated proteolysis of p75NTR1519.1×0.009PSEN1
NOTCH4 Activation and Transmission of Signal to the Nucleus1519.1×0.009PSEN1
Caspase-mediated cleavage of cytoskeletal proteins1475.8×0.009MAPT
TGFBR3 PTM regulation1475.8×0.009PSEN1
NRIF signals cell death from the nucleus1356.9×0.009PSEN1
Apoptotic cleavage of cellular proteins1237.9×0.009MAPT
Apoptotic execution phase1237.9×0.009MAPT
NOTCH3 Activation and Transmission of Signal to the Nucleus1237.9×0.009PSEN1
NOTCH2 Activation and Transmission of Signal to the Nucleus1219.6×0.009PSEN1
Activation of AMPK downstream of NMDARs1190.3×0.009MAPT
Activated NOTCH1 Transmits Signal to the Nucleus1178.4×0.009PSEN1
Nuclear signaling by ERBB41173.0×0.009PSEN1
EPH-ephrin mediated repulsion of cells1109.8×0.013PSEN1
Constitutive Signaling by NOTCH1 PEST Domain Mutants198.5×0.013PSEN1
Constitutive Signaling by NOTCH1 HD+PEST Domain Mutants198.5×0.013PSEN1
Apoptosis184.0×0.015MAPT
Programmed Cell Death173.2×0.016MAPT
PKR-mediated signaling170.5×0.016MAPT
Degradation of the extracellular matrix158.9×0.018PSEN1
Neutrophil degranulation111.5×0.085PSEN1

GO biological processes by enrichment

Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 2 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

GO termCohort genesFoldFDRSample cohort genes
astrocyte activation2991.3×1e-04MAPT, PSEN1
synapse organization2280.9×5e-04MAPT, PSEN1
regulation of synaptic plasticity2259.3×5e-04MAPT, PSEN1
learning or memory2240.7×5e-04MAPT, PSEN1
memory2183.2×7e-04MAPT, PSEN1
plus-end-directed organelle transport along microtubule18426.0×0.002MAPT
positive regulation of L-glutamate import across plasma membrane14213.0×0.002PSEN1
Cajal-Retzius cell differentiation14213.0×0.002PSEN1
smooth endoplasmic reticulum calcium ion homeostasis14213.0×0.002PSEN1
neurofibrillary tangle assembly14213.0×0.002MAPT
negative regulation of protein localization to mitochondrion14213.0×0.002MAPT
negative regulation of gene expression269.1×0.002MAPT, PSEN1
protein catabolic process at postsynapse12808.7×0.003PSEN1
astrocyte activation involved in immune response12106.5×0.003PSEN1
rRNA metabolic process12106.5×0.003MAPT
obsolete synaptic vesicle targeting12106.5×0.003PSEN1
axonal transport12106.5×0.003MAPT
positive regulation of protein localization to synapse12106.5×0.003MAPT
DNA damage response253.5×0.003MAPT, PSEN1
obsolete sequestering of calcium ion11685.2×0.003PSEN1
negative regulation of mitochondrial fission11685.2×0.003MAPT
regulation of long-term synaptic depression11685.2×0.003MAPT
positive regulation of amyloid fibril formation11685.2×0.003PSEN1
positive regulation of coagulation11404.3×0.004PSEN1
regulation of microtubule-based movement11404.3×0.004MAPT
intracellular distribution of mitochondria11203.7×0.004MAPT
regulation of mitochondrial fission11053.2×0.004MAPT
Notch receptor processing1936.2×0.004PSEN1
amyloid-beta formation1936.2×0.004PSEN1
L-glutamate import across plasma membrane1936.2×0.004PSEN1

Therapeutics

Drug target analysis

Approved (phase 4): 2 · Phase ≥3: 2 · Phased (≥1): 2 · Undrugged: 0

Druggability breadth: 2 of 2 evidence-associated genes (100%) have a ChEMBL target (buckets above are over the deeply-mined display cohort).

Genes with an approved drug

The molecule shown is one approved compound that hits the gene — not necessarily a drug of choice or one indicated for this disease.

SymbolExample approved molecule
MAPTBEPRIDIL
PSEN1NIROGACESTAT

Top cohort targets by molecule count

SymbolMoleculesMax phase
MAPT4494
PSEN184

Drugs targeting cohort genes (top 30)

MoleculeMax phaseTargets in cohort
BEPRIDIL4MAPT
PHENYLBUTAZONE4MAPT
CEFOTAXIME SODIUM4MAPT
DIENESTROL4MAPT
PROGESTERONE4MAPT
CLOTRIMAZOLE4MAPT
CHOLECALCIFEROL4MAPT
LATANOPROST4MAPT
CHLORTHALIDONE4MAPT
FLUORESCEIN4MAPT
OXCARBAZEPINE4MAPT
NABUMETONE4MAPT
GLIPIZIDE4MAPT
AMIODARONE HYDROCHLORIDE4MAPT
TRICLABENDAZOLE4MAPT
MESORIDAZINE4MAPT
INDIGOTINDISULFONATE4MAPT
TRIHEXYPHENIDYL HYDROCHLORIDE4MAPT
IMIPRAMINE4MAPT
FURAZOLIDONE4MAPT
DROPERIDOL4MAPT
ARIPIPRAZOLE4MAPT
RALOXIFENE HYDROCHLORIDE4MAPT
IDARUBICIN4MAPT
ACETAMINOPHEN4MAPT
ACITRETIN4MAPT
CISPLATIN4MAPT
CLOBETASOL PROPIONATE4MAPT
AMINOSALICYLIC ACID4MAPT
TETRABENAZINE4MAPT

Bioactivity and enzyme data

Enzyme cohort genes (≥1 EC): 0.

Cohort genes with ChEMBL bioactivity (full, sorted by assay count)

SymbolAssaysType breakdown
PSEN1557Binding:538, Functional:12, ADMET:6, Unclassified:1
MAPT184Binding:180, Functional:4

Cohort genes with high screening signal

≥100 ChEMBL assays — a studied-ness signal; see Therapeutics for approved-drug status.

SymbolChEMBL assays
MAPT184
PSEN1557

Pharmacogenomics

Cohort genes with a PharmGKB record: 2; with CPIC/DPWG dosing guidelines: 0.

No cohort gene has a CPIC/DPWG genotype-guided dosing guideline (PharmGKB).

Chemical tractability of cohort targets

30 approved/phased compounds have measured bioactivity against a cohort gene (and aren’t yet in disease-level trials). This is a research / tractability signal, NOT a therapeutic recommendation — a bioactivity row often reflects off-target or screening binding (e.g. promiscuous kinase inhibitors against a cohort kinase), implying no disease mechanism.

CompoundMax phaseCohort target (bioactivity)
BEPRIDIL4MAPT
PHENYLBUTAZONE4MAPT
CEFOTAXIME SODIUM4MAPT
DIENESTROL4MAPT
PROGESTERONE4MAPT
CLOTRIMAZOLE4MAPT
CHOLECALCIFEROL4MAPT
LATANOPROST4MAPT
CHLORTHALIDONE4MAPT
FLUORESCEIN4MAPT
OXCARBAZEPINE4MAPT
NABUMETONE4MAPT
GLIPIZIDE4MAPT
AMIODARONE HYDROCHLORIDE4MAPT
TRICLABENDAZOLE4MAPT
MESORIDAZINE4MAPT
INDIGOTINDISULFONATE4MAPT
TRIHEXYPHENIDYL HYDROCHLORIDE4MAPT
IMIPRAMINE4MAPT
FURAZOLIDONE4MAPT
DROPERIDOL4MAPT
ARIPIPRAZOLE4MAPT
RALOXIFENE HYDROCHLORIDE4MAPT
IDARUBICIN4MAPT
ACETAMINOPHEN4MAPT
ACITRETIN4MAPT
CISPLATIN4MAPT
CLOBETASOL PROPIONATE4MAPT
AMINOSALICYLIC ACID4MAPT
TETRABENAZINE4MAPT

Druggability pyramid

Cohort genes binned by druggability tier (high → low):

TierDefinitionGenesSymbols
AApproved (phase 4 drug)2MAPT, PSEN1
BPhased (≥1) drug, not yet approved0
CDruggable family + PDB, no drug0
DDruggable family + AlphaFold only, no drug0
EDifficult family or no structure, no drug0

Undrugged target profiles

0 cohort genes are undrugged. Ranked by ‘starting-point quality’ (assay depth + drugged-partner adjacency).

Clinical trials & evidence

Clinical trials

Clinical trials: 161.

Phase distribution (across all retrieved trials)

PhaseTrials
Not specified122
PHASE214
PHASE18
PHASE1/PHASE27
PHASE44
PHASE33
EARLY_PHASE13

Top trials by phase / activity

NCTPhaseStatusTitle
NCT00950430PHASE4ENROLLING_BY_INVITATIONImaging of Brain Amyloid Plaques in the Aging Population
NCT06093126PHASE4RECRUITINGLemborexant for Insomnia in a Patient With Dementia: An N-of-1 Trial
NCT00376051PHASE4COMPLETEDSerotonergic Function and Behavioural and Psychological Symptoms of Frontotemporal Dementia
NCT00545974PHASE4COMPLETEDMemantine (10mg BID) for the Frontal and Temporal Subtypes of Frontotemporal Dementia
NCT00594737PHASE3COMPLETEDOpen Label Pilot Study of the Effects of Memantine on FDG-PET in Frontotemporal Dementia
NCT03682185PHASE3COMPLETEDThe Healthy Patterns Sleep Study
NCT04374136PHASE3TERMINATEDA Phase 3 Study to Evaluate Efficacy and Safety of AL001 in Frontotemporal Dementia (INFRONT-3)
NCT04220021PHASE2ACTIVE_NOT_RECRUITINGSafety and Therapeutic Potential of the FDA-approved Drug Metformin for C9orf72 ALS/FTD
NCT04408625PHASE1/PHASE2ACTIVE_NOT_RECRUITINGPhase 1/2 Clinical Trial of LY3884963 in Patients With Frontotemporal Dementia With Progranulin Mutations (FTD-GRN)
NCT04747431PHASE1/PHASE2ACTIVE_NOT_RECRUITINGA Study of PBFT02 in Participants With FTD and Mutations in the Granulin Precursor (GRN) or C9ORF72 Genes
NCT05262023PHASE1/PHASE2ACTIVE_NOT_RECRUITINGA Study to Evaluate the Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of DNL593 in Healthy Participants and Participants With Frontotemporal Dementia (FTD-GRN)
NCT05374278PHASE1/PHASE2RECRUITINGFirst-in-Human Evaluation of an Astrocytic Glutamate Transporter (EAAT2) PET Tracer in Dementia
NCT05742698PHASE2RECRUITINGNabilone for Agitation in Frontotemporal Dementia
NCT06064890PHASE1/PHASE2RECRUITINGA Study to Evaluate the Safety and Effect of AVB-101, a Gene Therapy Product, in Subjects With a Genetic Sub-type of Frontotemporal Dementia (FTD-GRN)
NCT06604520PHASE2RECRUITINGVortioxetine for the Treatment of Mood and Cognitive Symptoms in Frontotemporal Dementia
NCT07154485PHASE2NOT_YET_RECRUITINGInvestigator Initiated Study for the Safety and Efficacy in Frontotemporal Dementia
NCT00416169PHASE2COMPLETEDA Pilot Study to Explore the Safety and Tolerability of Galantamine HBr in the Treatment of Pick Complex/Frontotemporal Dementia
NCT01890343PHASE2COMPLETEDImaging Characteristics of Florbetapir 18F in Patients With Frontotemporal Dementia, Alzheimer’s Disease and Normal Controls.
NCT01937013PHASE2COMPLETEDImpact of Emotional Mimicry and Oxytocin on Frontotemporal Dementia
NCT02676843PHASE2COMPLETEDTau PET Imaging With 18F-AV-1451 in Subjects With MAPT Mutations
NCT02862210PHASE2COMPLETEDLow-Dose Lithium for the Treatment of Behavioral Symptoms in Frontotemporal Dementia
NCT03260920PHASE2UNKNOWNIntranasal Oxytocin for Frontotemporal Dementia
NCT03987295PHASE2COMPLETEDA Phase 2 Study to Evaluate Safety of Long-term AL001 Dosing in Frontotemporal Dementia (FTD) Patients (INFRONT-2)
NCT04489017PHASE2COMPLETEDPalmitoylethanolamide Combined With Luteoline in Frontotemporal Dementia Patients. A Randomized Controlled Trial
NCT04931862PHASE1/PHASE2TERMINATEDStudy of WVE-004 in Patients With C9orf72-associated Amyotrophic Lateral Sclerosis (ALS) or Frontotemporal Dementia (FTD)
NCT04937452PHASE2COMPLETEDDopaminergic Therapy for Frontotemporal Dementia Patients
NCT04993755PHASE2COMPLETEDA Phase 2a Study of TPN-101 in Patients With C9ORF72 ALS/FTD
NCT05683860PHASE1/PHASE2TERMINATEDOpen-label Extension (OLE) Study of WVE-004 in Patients With C9orf72-associated Amyotrophic Lateral Sclerosis (ALS) and/or Frontotemporal Dementia (FTD)
NCT05184569PHASE1RECRUITINGVeri-T: A Trial of Verdiperstat in Patients With svPPA Due to TDP-43 Pathology
NCT05315661PHASE1ACTIVE_NOT_RECRUITINGThe Safety and The Efficacy Evaluation of ET-STEM in Patients With Frontotemporal Dementia
NCT01386333PHASE1COMPLETEDSafety Study of Intranasal Oxytocin in Frontotemporal Dementia
NCT01623284PHASE1COMPLETEDPiB PET Scanning in Speech and Language Based Dementias
NCT03040713PHASE1COMPLETEDFlortaucipir PET Imaging in Subjects With FTD
NCT03636204PHASE1COMPLETEDA First in Human Study in Healthy Volunteers and in Participants With Frontotemporal Dementia With Granulin (GRN) Mutation
NCT06226064PHASE1COMPLETEDA Study to Evaluate the Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of VES001 in Healthy Participants
NCT06705192PHASE1COMPLETEDStudy in Asymptomatic GRN-FTD Patients to Investigate the Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of VES001
NCT06891716EARLY_PHASE1RECRUITING[18F]ACI-19626 PET in TDP-43 Proteinopathies
NCT03510572EARLY_PHASE1COMPLETEDEvaluation of [18F]PI-2620 as a Potential Positron Emission Computed Tomography Radioligand for Imaging Tau Protein in the Brain
NCT03625128EARLY_PHASE1COMPLETED18F-PM-PBB3 PET Study in Tauopathy Including Alzheimer’s Disease, Other Dementias and Normal Controls
NCT01353430Not specifiedRECRUITINGCharacterization of Inclusion Body Myopathy Associated With Paget’s Disease of Bone and Frontotemporal Dementia (IBMPFD)

Drugs tested across these trials (top 30)

MoleculeMax phaseTrials referencing
CITALOPRAM43
FLORBETAPIR43
MEMANTINE43
FLORTAUCIPIR F 1842
ESCITALOPRAM41
FLUDEOXYGLUCOSE F 1841
FLUTEMETAMOL41
GALANTAMINE HYDROBROMIDE41
LEMBOREXANT41
LITHIUM CARBONATE41
NABILONE41
ROTIGOTINE41
VORTIOXETINE41
LATOZINEMAB33
FLUORIDE ION F-1831
LEUCINE31
VERDIPERSTAT31
COSFROVIXIMAB21
PITTSBURGH COMPOUND B21
CHEMBL49856301
CHEMBL518904601
CHEMBL10438301
F-1801