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Restrepo-Martínez M, Ramirez-Bermudez J, Chacon-Gonzalez J, Ruiz-Garcia R, Malik R, Finger E. Defining repetitive behaviours in frontotemporal dementia. Brain 2024; 147:1149-1165. [PMID: 38134315 DOI: 10.1093/brain/awad431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 11/08/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
Repetitive behaviours are common manifestations of frontotemporal dementia (FTD). Patients with FTD exhibit various types of repetitive behaviours with unique behavioural and cognitive substrates, including compulsivity, lack of impulse control, stereotypy and hoarding. Other sources of repetitive behaviours, such as restrictive interests and insistence on sameness, may also be seen in FTD. Although repetitive behaviours are highly prevalent and potentially discriminatory in this population, their expression varies widely between patients, and the field lacks consensus about the classification of these behaviours. Terms used to describe repetitive behaviours in FTD are highly heterogeneous and may lack precise definitions. This lack of harmonization of the definitions for distinct forms of repetitive behaviour limits the ability to differentiate between pathological behaviours and impedes understanding of their underlying mechanisms. This review examines established definitions of well-characterized repetitive behaviours in other neuropsychiatric disorders and proposes operational definitions applicable to patients with FTD. Building on extant models of repetitive behaviours in non-human and lesion work and models of social behavioural changes in FTD, we describe the potential neurocognitive bases for the emergence of different types of repetitive behaviours in FTD and their potential perpetuation by a predisposition towards habit formation. Finally, examples of distinct therapeutic approaches for different forms of repetitive behaviours are highlighted, along with future directions to accurately classify, measure and treat these symptoms when they impair quality of life.
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Affiliation(s)
- Miguel Restrepo-Martínez
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5C1, Canada
- Deparment of Cognitive Neurology, Parkwood Institute, London, ON N6C 5J1, Canada
| | - Jesus Ramirez-Bermudez
- Department of Neuropsychiatry, National Institute of Neurology and Neurosurgery Manuel Velasco Suarez, Mexico City, 14269, Mexico
| | - Jacobo Chacon-Gonzalez
- Department of Neuropsychiatry, National Institute of Neurology and Neurosurgery Manuel Velasco Suarez, Mexico City, 14269, Mexico
| | - Ramiro Ruiz-Garcia
- Department of Neuropsychiatry, National Institute of Neurology and Neurosurgery Manuel Velasco Suarez, Mexico City, 14269, Mexico
| | - Rubina Malik
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5C1, Canada
- Deparment of Cognitive Neurology, Parkwood Institute, London, ON N6C 5J1, Canada
| | - Elizabeth Finger
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5C1, Canada
- Deparment of Cognitive Neurology, Parkwood Institute, London, ON N6C 5J1, Canada
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Liu D, Schwieter JW, Liu W, Mu L, Liu H. The COMT gene modulates the relationship between bilingual adaptation in executive function and decision-making: an EEG study. Cogn Neurodyn 2023; 17:893-907. [PMID: 37522041 PMCID: PMC10374516 DOI: 10.1007/s11571-022-09867-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/11/2022] [Accepted: 07/27/2022] [Indexed: 11/30/2022] Open
Abstract
Bilingual adaptive control mechanisms appear to be linked to congenital genetic factors such as dopamine (DA) genes. However, it is unclear as to whether acquired cognitive exercise can vanquish innate influences that allow bilingual executive advantages to be shown in other cognitive areas. In the present study, we examine the relationship between gene-dependent executive control and decision-making by targeting the enzyme catecholamine-O-methyltransferase (COMT) and employing electroencephalography (EEG). Chinese-English bilinguals (N = 101) participated in a language switching task and the Iowa Gambling Task (IGT). The findings showed that COMT Val158Met polymorphism played a complex role in decision-making and bilingual executive control processing: Bilinguals with Valine (Val) homozygotes had poorer performance in the IGT, while Methionine (Met) carriers had larger switch costs in the language switching task. Second, the cross-task relationships varied among bilinguals with different COMT genotypes: Bilinguals with Met allele genotypes showed larger switch costs and better performance on the IGT. These findings suggest that bilinguals who carry Met allele are equipped with more efficient adaptive mechanisms of executive functions that are generalized to other cognitive domains. Supplementary Information The online version contains supplementary material available at 10.1007/s11571-022-09867-2.
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Affiliation(s)
- Dongxue Liu
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, 116029 China
- Key Laboratory of Brain and Cognitive Neuroscience, Dalian, 116029 Liaoning Province China
| | - John W. Schwieter
- Language Acquisition, Multilingualism, and Cognition Laboratory / Bilingualism Matters, Wilfrid Laurier University, Waterloo, Canada
| | - Wenxin Liu
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, 116029 China
- Key Laboratory of Brain and Cognitive Neuroscience, Dalian, 116029 Liaoning Province China
| | - Li Mu
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, 116029 China
- Key Laboratory of Brain and Cognitive Neuroscience, Dalian, 116029 Liaoning Province China
| | - Huanhuan Liu
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, 116029 China
- Key Laboratory of Brain and Cognitive Neuroscience, Dalian, 116029 Liaoning Province China
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Henríquez F, Cabello V, Baez S, de Souza LC, Lillo P, Martínez-Pernía D, Olavarría L, Torralva T, Slachevsky A. Multidimensional Clinical Assessment in Frontotemporal Dementia and Its Spectrum in Latin America and the Caribbean: A Narrative Review and a Glance at Future Challenges. Front Neurol 2022; 12:768591. [PMID: 35250791 PMCID: PMC8890568 DOI: 10.3389/fneur.2021.768591] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 12/13/2021] [Indexed: 12/14/2022] Open
Abstract
Frontotemporal dementia (FTD) is the third most common form of dementia across all age groups and is a leading cause of early-onset dementia. The Frontotemporal dementia (FTD) includes a spectrum of diseases that are classified according to their clinical presentation and patterns of neurodegeneration. There are two main types of FTD: behavioral FTD variant (bvFTD), characterized by a deterioration in social function, behavior, and personality; and primary progressive aphasias (PPA), characterized by a deficit in language skills. There are other types of FTD-related disorders that present motor impairment and/or parkinsonism, including FTD with motor neuron disease (FTD-MND), progressive supranuclear palsy (PSP), and corticobasal syndrome (CBS). The FTD and its associated disorders present great clinical heterogeneity. The diagnosis of FTD is based on the identification through clinical assessments of a specific clinical phenotype of impairments in different domains, complemented by an evaluation through instruments, i.e., tests and questionnaires, validated for the population under study, thus, achieving timely detection and treatment. While the prevalence of dementia in Latin America and the Caribbean (LAC) is increasing rapidly, there is still a lack of standardized instruments and consensus for FTD diagnosis. In this context, it is important to review the published tests and questionnaires adapted and/or validated in LAC for the assessment of cognition, behavior, functionality, and gait in FTD and its spectrum. Therefore, our paper has three main goals. First, to present a narrative review of the main tests and questionnaires published in LAC for the assessment of FTD and its spectrum in six dimensions: (i) Cognitive screening; (ii) Neuropsychological assessment divided by cognitive domain; (iii) Gait assessment; (iv) Behavioral and neuropsychiatric symptoms; (v) Functional assessment; and (vi) Global Rating Scale. Second, to propose a multidimensional clinical assessment of FTD in LAC identifying the main gaps. Lastly, it is proposed to create a LAC consortium that will discuss strategies to address the current challenges in the field.
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Affiliation(s)
- Fernando Henríquez
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department – Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
- Laboratory for Cognitive and Evolutionary Neuroscience (LaNCE), Department of Psychiatry, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Victoria Cabello
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department – Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Sandra Baez
- Universidad de los Andes, Departamento de Psicología, Bogotá, Colombia
| | - Leonardo Cruz de Souza
- Programa de Pós-Graduação em Neurociências da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
- Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Patricia Lillo
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Departamento de Neurología Sur, Facultad de Medicina, Universidad de Chile, Santiago, Chile
- Unidad de Neurología, Hospital San José, Santiago, Chile
| | - David Martínez-Pernía
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
| | - Loreto Olavarría
- Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department – Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Teresa Torralva
- Institute of Cognitive and Translational Neuroscience (INCYT), Instituto de Neurología Cognitiva Foundation, Favaloro University, Buenos Aires, Argentina
| | - Andrea Slachevsky
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department – Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
- Department of Neurology and Psychiatry, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
- *Correspondence: Andrea Slachevsky
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Custodio N, Montesinos R, Cruzado L, Herrera-Perez E, Failoc-Rojas VE, Pintado-Caipa M, Seminario G W, Cuenca J, Gamboa C, Diaz MM. Social Cognition and Behavioral Assessments Improve the Diagnosis of Behavioral Variant of Frontotemporal Dementia in Older Peruvians With Low Educational Levels. Front Neurol 2021; 12:704109. [PMID: 34552551 PMCID: PMC8450322 DOI: 10.3389/fneur.2021.704109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 07/07/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The behavioral variant of frontotemporal dementia (bvFTD), characterized by early behavioral abnormalities and late memory impairment, is a neurodegenerative disorder with a detrimental impact on patients and their caregivers. bvFTD is often difficult to distinguish from other neurodegenerative diseases, such as Alzheimer's disease (AD), using brief cognitive tests. Combining brief socio-cognitive and behavioral evaluations with standard cognitive testing could better discriminate bvFTD from AD patients. We sought to evaluate the diagnostic accuracy of brief socio-cognitive tests that may differentiate bvFTD and AD patients with low educational levels. Methods: A prospective study was performed on 51 individuals over the age of 50 with low educational levels, with bvFTD or AD diagnosed using published criteria, and who were receiving neurological care at a multidisciplinary neurology clinic in Lima, Peru, between July 2017 and December 2020. All patients had a comprehensive neurological evaluation, including a full neurocognitive battery and brief tests of cognition (Addenbrooke's Cognitive Examination version III, ACE-III), social cognition (Mini-social Cognition and Emotional Assessment, Mini-SEA), and behavioral assessments (Frontal Behavioral Inventory, FBI; Interpersonal Reactivity Index-Emphatic Concern, IRI-EC; IRI-Perspective Taking, IRI-PT; and Self-Monitoring Scale-revised version, r-SMS). Receiver operating characteristic (ROC) analysis to calculate the area under the curve (AUC) was performed to compare the brief screening tests individually and combined to the gold standard of bvFTD and AD diagnoses. Results: The AD group was significantly older than the bvFTD group (p < 0.001). An analysis of the discriminatory ability of the ACE-III to distinguish between patients with AD and bvFTD (AUC = 0.85) and the INECO Frontal Screening (IFS; AUC = 0.78) shows that the former has greater discriminatory ability. Social and behavioral cognition tasks were able to appropriately discriminate bvFTD from AD. The Mini-SEA had high sensitivity and high moderate specificity (83%) for discriminating bvFTD from AD, which increased when combined with the brief screening tests ACE-III and IFS. The FBI was ideal with high sensitivity (83%), as well as the IRI-EC and IRI-PT that also were adequate for distinguishing bvFTD from AD. Conclusions: Our study supports the integration of socio-behavioral measures to the standard global cognitive and social cognition measures utilized for screening for bvFTD in a population with low levels of education.
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Affiliation(s)
- Nilton Custodio
- Servicio de Neurología, Instituto Peruano de Neurociencias, Lince, Peru
- Unidad de Diagnóstico de Deterioro Cognitivo y Prevención De Demencia, Instituto Peruano de Neurociencias, Lince, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lince, Peru
| | - Rosa Montesinos
- Unidad de Diagnóstico de Deterioro Cognitivo y Prevención De Demencia, Instituto Peruano de Neurociencias, Lince, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lince, Peru
- Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Lizardo Cruzado
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lince, Peru
- Instituto Nacional de Salud Mental “Honorio Delgado—Hideyo Noguchi”, Lima, Peru
- Grupo de investigación Molident, Universidad San Ignacio de Loyola, Lima, Peru
| | - Eder Herrera-Perez
- Unidad de Diagnóstico de Deterioro Cognitivo y Prevención De Demencia, Instituto Peruano de Neurociencias, Lince, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lince, Peru
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
| | - Virgilio E. Failoc-Rojas
- Unidad de Diagnóstico de Deterioro Cognitivo y Prevención De Demencia, Instituto Peruano de Neurociencias, Lince, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lince, Peru
| | - Maritza Pintado-Caipa
- Servicio de Neurología, Instituto Peruano de Neurociencias, Lince, Peru
- Unidad de Diagnóstico de Deterioro Cognitivo y Prevención De Demencia, Instituto Peruano de Neurociencias, Lince, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lince, Peru
- Atlantic Fellow, Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
| | - Wendy Seminario G
- Servicio de Neurología, Instituto Peruano de Neurociencias, Lince, Peru
- Unidad de Diagnóstico de Deterioro Cognitivo y Prevención De Demencia, Instituto Peruano de Neurociencias, Lince, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lince, Peru
| | - José Cuenca
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lince, Peru
- Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru
- Servicio de Neuropsicología, Instituto Peruano de Neurociencias, Lima, Peru
- Carrera de Psicología, Facultad de Ciencias de la Salud, Universidad Privada del Norte, Lima, Peru
| | - Carlos Gamboa
- Unidad de Diagnóstico de Deterioro Cognitivo y Prevención De Demencia, Instituto Peruano de Neurociencias, Lince, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lince, Peru
- Servicio de Neuropsicología, Instituto Peruano de Neurociencias, Lima, Peru
| | - Monica M. Diaz
- Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
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Oberrauch S, Metha JA, Brian ML, Barnes SA, Featherby TJ, Lawrence AJ, Hoyer D, Murawski C, Jacobson LH. Reward motivation and cognitive flexibility in tau null-mutation mice. Neurobiol Aging 2021; 100:106-117. [PMID: 33524848 DOI: 10.1016/j.neurobiolaging.2020.12.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 11/05/2020] [Accepted: 12/15/2020] [Indexed: 01/21/2023]
Abstract
The reduction of tau or hyperphosphorylated tau (p-tau) has been proposed as a therapeutic strategy for Alzheimer's disease (AD) and frontotemporal dementia (FTD). Cognitive decline and sleep-wake dysregulation seen in AD and FTD patients are mimicked in transgenic and null-mutation mouse models of tauopathy. Alterations in the reward system are additional symptoms of AD and FTD. However, the role of tau in reward processes is not well understood. The present study aimed to examine reward and reward-motivated cognitive processes in male and female tau knockout (tau-/-) and wild-type mice using progressive ratio and reversal learning tasks. Tau-/- mice were heavier, ate more in the home cage, and reached criterion in operant lever training faster than wild-type mice. Tau-/- mice had a higher breakpoint in progressive ratio but were unimpaired in reversal learning or reward sensitivity. These data indicate that tau loss of function alters reward processing. This may help to explain aberrant reward-related behaviors in tauopathy patients and highlights a potentially important area for consideration in the development of anti-tau therapies.
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Affiliation(s)
- Sara Oberrauch
- The Florey Institute of Neuroscience and Mental Health, Parkville Campus, University of Melbourne, Parkville, Australia; Department of Pharmacology & Therapeutics, School of Medicine, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Jeremy A Metha
- The Florey Institute of Neuroscience and Mental Health, Parkville Campus, University of Melbourne, Parkville, Australia; Department of Pharmacology & Therapeutics, School of Medicine, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria, Australia; Department of Finance, Brain, Mind & Markets Laboratory, The University of Melbourne, Melbourne, Victoria, Australia
| | - Maddison L Brian
- The Florey Institute of Neuroscience and Mental Health, Parkville Campus, University of Melbourne, Parkville, Australia; Department of Pharmacology & Therapeutics, School of Medicine, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Samuel A Barnes
- Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Travis J Featherby
- The Florey Institute of Neuroscience and Mental Health, Parkville Campus, University of Melbourne, Parkville, Australia
| | - Andrew J Lawrence
- The Florey Institute of Neuroscience and Mental Health, Parkville Campus, University of Melbourne, Parkville, Australia
| | - Daniel Hoyer
- The Florey Institute of Neuroscience and Mental Health, Parkville Campus, University of Melbourne, Parkville, Australia; Department of Pharmacology & Therapeutics, School of Medicine, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria, Australia; Department of Molecular Medicine, The Scripps Research Institute, La Jolla, CA, USA
| | - Carsten Murawski
- Department of Finance, Brain, Mind & Markets Laboratory, The University of Melbourne, Melbourne, Victoria, Australia
| | - Laura H Jacobson
- The Florey Institute of Neuroscience and Mental Health, Parkville Campus, University of Melbourne, Parkville, Australia; Department of Pharmacology & Therapeutics, School of Medicine, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria, Australia; Melbourne Dementia Research Centre, The Florey Institute of Neuroscience and Mental Health and The University of Melbourne, Victoria, Australia.
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Pozueta A, Lage C, García-Martínez M, Kazimierczak M, Bravo M, López-García S, Riancho J, González-Suarez A, Vázquez-Higuera JL, de Arcocha-Torres M, Banzo I, Jiménez-Bonilla J, Berciano J, Rodríguez-Rodríguez E, Sánchez-Juan P. Cognitive and Behavioral Profiles of Left and Right Semantic Dementia: Differential Diagnosis with Behavioral Variant Frontotemporal Dementia and Alzheimer's Disease. J Alzheimers Dis 2020; 72:1129-1144. [PMID: 31683488 DOI: 10.3233/jad-190877] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Semantic dementia (SD) is a subtype of frontotemporal dementia (FTD) characterized by semantic memory loss and preserved abilities of other cognitive functions. The clinical manifestations of SD require a differential diagnosis with Alzheimer's disease (AD), especially those with early onset, and behavioral variant FTD (bvFTD). OBJECTIVE The present study aimed to compare cognitive performances and neuropsychiatric symptoms in a population of AD, bvFTD, and left and right SD defined with the support of molecular imaging (amyloid and 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography) and assessed the accuracy of different neuropsychological markers in distinguishing these neurodegenerative diseases. METHODS Eighty-seven participants (32 AD, 20 bvFTD, and 35 SD (17 Left-SD and 18 Right-SD) completed a comprehensive neuropsychological battery that included memory, language, attention and executive functions, visuospatial function, visuoconstructional skills, and tasks designed specifically to evaluate prosopagnosia and facial emotions recognition. The Neuropsychiatric Inventory was administered to assess neuropsychiatric symptoms. RESULTS An episodic memory test that included semantic cues, a visuospatial test (both impaired in AD), a naming test and a prosopagnosia task (both impaired in SD) were the four most valuable cognitive metrics for the differential diagnosis between groups. Several behavioral abnormalities were differentially present, of which aggression, self-care (both more frequent in bvFTD), and eating habits, specifically overeating and altered dietary preference (more frequent in SD), were the most valuable in group discrimination. CONCLUSION Our study highlights the value of a comprehensive neuropsychological and neuropsychiatric evaluation for the differential diagnosis between FTD syndromes and AD.
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Affiliation(s)
- Ana Pozueta
- Neurology Service and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), 'Marqués de Valdecilla' University Hospital, University of Cantabria, Institute for Research 'Marqués de Valdecilla' (IDIVAL), Santander, Spain
| | - Carmen Lage
- Neurology Service and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), 'Marqués de Valdecilla' University Hospital, University of Cantabria, Institute for Research 'Marqués de Valdecilla' (IDIVAL), Santander, Spain
| | - María García-Martínez
- Neurology Service and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), 'Marqués de Valdecilla' University Hospital, University of Cantabria, Institute for Research 'Marqués de Valdecilla' (IDIVAL), Santander, Spain
| | - Martha Kazimierczak
- Neurology Service and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), 'Marqués de Valdecilla' University Hospital, University of Cantabria, Institute for Research 'Marqués de Valdecilla' (IDIVAL), Santander, Spain
| | - María Bravo
- Neurology Service and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), 'Marqués de Valdecilla' University Hospital, University of Cantabria, Institute for Research 'Marqués de Valdecilla' (IDIVAL), Santander, Spain
| | - Sara López-García
- Neurology Service and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), 'Marqués de Valdecilla' University Hospital, University of Cantabria, Institute for Research 'Marqués de Valdecilla' (IDIVAL), Santander, Spain
| | - Javier Riancho
- Neurology Service and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Sierrallana, Institute for Research 'Marqués de Valdecilla' (IDIVAL), Santander, Spain
| | - Andrea González-Suarez
- Neurology Service and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), 'Marqués de Valdecilla' University Hospital, University of Cantabria, Institute for Research 'Marqués de Valdecilla' (IDIVAL), Santander, Spain
| | - José Luis Vázquez-Higuera
- Neurology Service and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), 'Marqués de Valdecilla' University Hospital, University of Cantabria, Institute for Research 'Marqués de Valdecilla' (IDIVAL), Santander, Spain
| | - María de Arcocha-Torres
- Department of Nuclear Medicine, University Hospital 'Marqués de Valdecilla', University of Cantabria, Molecular imaging Group - IDIVAL, Santander, Spain
| | - Ignacio Banzo
- Department of Nuclear Medicine, University Hospital 'Marqués de Valdecilla', University of Cantabria, Molecular imaging Group - IDIVAL, Santander, Spain
| | - Julio Jiménez-Bonilla
- Department of Nuclear Medicine, University Hospital 'Marqués de Valdecilla', University of Cantabria, Molecular imaging Group - IDIVAL, Santander, Spain
| | - José Berciano
- Neurology Service and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), 'Marqués de Valdecilla' University Hospital, University of Cantabria, Institute for Research 'Marqués de Valdecilla' (IDIVAL), Santander, Spain
| | - Eloy Rodríguez-Rodríguez
- Neurology Service and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), 'Marqués de Valdecilla' University Hospital, University of Cantabria, Institute for Research 'Marqués de Valdecilla' (IDIVAL), Santander, Spain
| | - Pascual Sánchez-Juan
- Neurology Service and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), 'Marqués de Valdecilla' University Hospital, University of Cantabria, Institute for Research 'Marqués de Valdecilla' (IDIVAL), Santander, Spain
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Abstract
Impulse control disorders (ICDs) are neuropsychiatric conditions characterized by the repeated inability to resist an impulse, drive, or temptation to perform an act that is harmful to the person or others. Although classification approaches to ICDs vary both diachronically and synchronically, this group of conditions encompasses a wide range of syndromes, including pathologic gambling, kleptomania, trichotillomania, excoriation (skin picking) disorder, intermittent explosive disorder, pyromania, oppositional defiant, conduct, and antisocial personality disorders. ICDs can play a significant role as comorbidities in both neurodevelopmental (eg, attention-deficit/hyperactivity disorder, Tourette syndrome) and neurodegenerative (eg, Parkinson disease) disorders.
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Affiliation(s)
- Bruno Silva
- Department of Neuropsychiatry, Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK; NOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Hugo Canas-Simião
- Department of Psychiatry, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - Andrea E Cavanna
- Department of Neuropsychiatry, Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK; Institute of Clinical Sciences, University of Birmingham, Birmingham, UK; School of Life and Health Sciences, Aston University, Birmingham, UK; Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, London, UK.
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8
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Novel insights into "hot" executive functioning profiles in elderly individuals. Int Psychogeriatr 2020; 32:669-671. [PMID: 32616116 DOI: 10.1017/s1041610219001169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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9
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Bretag-Norris R, Gallur L, Flynn P. Heterogeneity in the psychiatric presentation of behavioural variant frontotemporal dementia (bvFTD). Australas Psychiatry 2019; 27:491-495. [PMID: 31310153 DOI: 10.1177/1039856219860031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE This article describes how the onset of bvFTD can be heralded by psychiatric symptoms. METHOD Case reports are described with reference to the relevant literature review. RESULTS Three patients were admitted with psychiatric symptoms, including depression, mania, psychosis and catatonia. Two had been previously diagnosed with a psychiatric disorder. All three were diagnosed with probable bvFTD. CONCLUSION bvFTD is an important differential diagnosis to consider when patients present with atypical psychiatric symptoms.
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Affiliation(s)
- Reece Bretag-Norris
- Central Adelaide Local Health Network, Adelaide, SA, and; School of Medicine, Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - Lara Gallur
- Northern Adelaide Local Health Network, Adelaide, SA, and; School of Medicine, Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - Patrick Flynn
- Central Adelaide Local Health Network, Adelaide, SA, Australia
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Reddy PV, Anuroop L, Shetageri V, Kumar RK, Gopalakrishnan G. A Case of Frontotemporal Dementia Presenting as Nicotine Dependence and Carbohydrate Craving. Indian J Psychol Med 2019; 41:391-393. [PMID: 31391675 PMCID: PMC6657478 DOI: 10.4103/ijpsym.ijpsym_390_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Preethi V Reddy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Lavanya Anuroop
- Department of Psychiatry, M V Jayaram Medical College and Research Centre, Bangalore, Karnataka, India
| | - Veda Shetageri
- Department of Psychiatry, M V Jayaram Medical College and Research Centre, Bangalore, Karnataka, India
| | - Raghavendra K Kumar
- Department of Child Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Ganeshan Gopalakrishnan
- Department of Psychiatry, M V Jayaram Medical College and Research Centre, Bangalore, Karnataka, India
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11
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Battista P, Capozzo R, Rizzo G, Zecca C, Anastasia A, De Blasi R, Logroscino G. Early pathological gambling in co-occurrence with semantic variant primary progressive aphasia: a case report. Clin Interv Aging 2019; 14:727-733. [PMID: 31114177 PMCID: PMC6497882 DOI: 10.2147/cia.s197484] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Accepted: 02/23/2019] [Indexed: 12/02/2022] Open
Abstract
We have comprehensively documented a case of semantic variant of primary progressive aphasia (sv-PPA) presenting with early-onset pathological gambling (PG). While a growing number of studies have shown the presence of behavioral alterations in patients with sv-PPA, PG has been observed only in the behavioral variant of frontotemporal dementia (bv-FTD). To date, no case of PG with the co-occurrence of prominent semantic deficits at the onset of the disease has been reported in the literature. Impulse disorders at onset may wrongly lead to a misdiagnosis (ie, psychiatric disorders). Therefore, a wider characterization of cognitive/aphasia symptoms in patients presenting impulse disorders and predominant language dysfunctions is recommended.
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Affiliation(s)
- Petronilla Battista
- Istituti Clinici Scientifici Maugeri-SPA SB. I.R.C.C.S. Institute of Cassano Murge, Bari, Italy
- Neurodegenerative Disease Unit, Department of Clinical Research in Neurology, University of Bari Aldo Moro, “Pia Fondazione Cardinale G. Panico”, Tricase, Italy
| | - Rosa Capozzo
- Neurodegenerative Disease Unit, Department of Clinical Research in Neurology, University of Bari Aldo Moro, “Pia Fondazione Cardinale G. Panico”, Tricase, Italy
| | - Giovanni Rizzo
- UOC Clinica Neurologica, IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Chiara Zecca
- Neurodegenerative Disease Unit, Department of Clinical Research in Neurology, University of Bari Aldo Moro, “Pia Fondazione Cardinale G. Panico”, Tricase, Italy
| | - Antonio Anastasia
- Department of Nuclear Medicine, Pia Fondazione di Culto e Religione “Card.G.Panico”, Tricase, Italy
| | - Roberto De Blasi
- Department of Diagnostic Imaging, Pia Fondazione di Culto e Religione “Card.G.Panico”, Tricase, Italy
| | - Giancarlo Logroscino
- Neurodegenerative Disease Unit, Department of Clinical Research in Neurology, University of Bari Aldo Moro, “Pia Fondazione Cardinale G. Panico”, Tricase, Italy
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
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12
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Convery R, Mead S, Rohrer JD. Review: Clinical, genetic and neuroimaging features of frontotemporal dementia. Neuropathol Appl Neurobiol 2019; 45:6-18. [DOI: 10.1111/nan.12535] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 12/10/2018] [Indexed: 12/12/2022]
Affiliation(s)
- R. Convery
- Dementia Research Centre; Department of Neurodegenerative Disease; UCL Queen Square Institute of Neurology; London UK
| | - S. Mead
- UCL Institute of Prion Diseases; MRC Prion Unit at UCL; London UK
| | - J. D. Rohrer
- Dementia Research Centre; Department of Neurodegenerative Disease; UCL Queen Square Institute of Neurology; London UK
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13
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Cipriani G, Nuti A, Danti S, Picchi L, Di Fiorino M. Uncommon and/or bizarre features of dementia: Part III. Acta Neurol Belg 2018; 118:211-216. [PMID: 29721853 DOI: 10.1007/s13760-018-0936-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 04/23/2018] [Indexed: 11/24/2022]
Abstract
Clinical neurologists have long recognized that dementia can present as atypical or variant syndromes/symptoms. This study aimed at describing uncommon or bizarre symptoms/syndromes observed in patients suffering from dementia. Medline and Google scholar searches were conducted for relevant articles, chapters, and books published before 2018. Search terms used included compulsion, dementia, extracampine hallucination, disordered gambling, humour, and obsession. Publications found through this indexed search were reviewed for further relevant references. The uncommon/bizarre feature of dementia was described as case reports and there were no systematic investigations.
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Affiliation(s)
- Gabriele Cipriani
- Department of Neurology, Versilia Hospital, Via Aurelia, Lido di Camaiore, Camaiore, Italy.
- Department of Psychiatry, Versilia Hospital, Camaiore, Italy.
| | - Angelo Nuti
- Department of Neurology, Versilia Hospital, Via Aurelia, Lido di Camaiore, Camaiore, Italy
| | - Sabrina Danti
- Psychology Unit, Hospital of Pontedera, Pontedera, Italy
| | - Lucia Picchi
- Psychology Unit, Hospital of Livorno, Leghorn, Italy
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Ouerchefani R, Ouerchefani N, Allain P, Ben Rejeb MR, Le Gall D. Relationships between executive function, working memory, and decision-making on the Iowa Gambling Task: Evidence from ventromedial patients, dorsolateral patients, and normal subjects. J Neuropsychol 2018; 13:432-461. [PMID: 29667317 DOI: 10.1111/jnp.12156] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 03/11/2018] [Indexed: 11/30/2022]
Abstract
The results of previous studies are inconsistent in regard to the relationship between the Iowa Gambling Task (IGT), working-memory (WM), and executive tasks, and whether these cognitive processes could be considered as mechanisms underlying a decision-making deficit. Moreover, the relationship between the IGT and executive measures is examined based on a limited number of executive tasks, within different populations showing diffuse damage. In addition, there are fewer studies carried out within control participants, with those studies also being inconclusive. It is also suggested that the association of the IGT performance with executive tasks depends on whether the IGT was running under ambiguity or under risk. In this work, all of these issues are studied. Results showed that both patients with ventromedial (VMPFC, N = 10) and dorsolateral (DLPFC, N = 10) prefrontal cortex lesions are significantly impaired on almost all executive tasks, WM tasks, and the IGT. Furthermore, when the IGT is run under risk, there are significant correlations between executive measures and the IGT for the DLPFC patients and the control participants (N = 34) but not the VMPFC patients. No correlation was found between WM tasks and the IGT for both frontal subgroups and control participants. These findings suggested that the mechanisms underlying the IGT deficit differ according to the lesion locations.
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Affiliation(s)
- Riadh Ouerchefani
- High Institute of Human Sciences, University of Tunis El Manar, Tunis, Tunisia.,Laboratory of Psychology of Pays de la Loire (EA 4638), University of Angers, France
| | | | - Philippe Allain
- Laboratory of Psychology of Pays de la Loire (EA 4638), University of Angers, France
| | | | - Didier Le Gall
- Laboratory of Psychology of Pays de la Loire (EA 4638), University of Angers, France
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15
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Roberts S, Henry JD, Molenberghs P. Immoral behaviour following brain damage: A review. J Neuropsychol 2018; 13:564-588. [DOI: 10.1111/jnp.12155] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 02/21/2018] [Indexed: 12/30/2022]
Affiliation(s)
- Stefanie Roberts
- School of Psychological Sciences Monash Institute of Cognitive and Clinical Neurosciences Monash University Clayton Victoria Australia
| | - Julie D. Henry
- School of Psychology University of Queensland St Lucia Queensland Australia
| | - Pascal Molenberghs
- School of Psychological Sciences The University of Melbourne Parkville Victoria Australia
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16
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Ibáñez A, García AM, Esteves S, Yoris A, Muñoz E, Reynaldo L, Pietto ML, Adolfi F, Manes F. Social neuroscience: undoing the schism between neurology and psychiatry. Soc Neurosci 2018; 13:1-39. [PMID: 27707008 DOI: 10.1080/17470919.2016.1245214] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Multiple disorders once jointly conceived as "nervous diseases" became segregated by the distinct institutional traditions forged in neurology and psychiatry. As a result, each field specialized in the study and treatment of a subset of such conditions. Here we propose new avenues for interdisciplinary interaction through a triangulation of both fields with social neuroscience. To this end, we review evidence from five relevant domains (facial emotion recognition, empathy, theory of mind, moral cognition, and social context assessment), highlighting their common disturbances across neurological and psychiatric conditions and discussing their multiple pathophysiological mechanisms. Our proposal is anchored in multidimensional evidence, including behavioral, neurocognitive, and genetic findings. From a clinical perspective, this work paves the way for dimensional and transdiagnostic approaches, new pharmacological treatments, and educational innovations rooted in a combined neuropsychiatric training. Research-wise, it fosters new models of the social brain and a novel platform to explore the interplay of cognitive and social functions. Finally, we identify new challenges for this synergistic framework.
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Affiliation(s)
- Agustín Ibáñez
- a Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation , Favaloro University , Buenos Aires , Argentina
- b National Scientific and Technical Research Council (CONICET) , Buenos Aires , Argentina
- c Center for Social and Cognitive Neuroscience (CSCN), School of Psychology , Universidad Adolfo Ibáñez , Santiago de Chile , Chile
- d Universidad Autónoma del Caribe , Barranquilla , Colombia
- e Centre of Excellence in Cognition and its Disorders , Australian Research Council (ACR) , Sydney , Australia
| | - Adolfo M García
- a Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation , Favaloro University , Buenos Aires , Argentina
- b National Scientific and Technical Research Council (CONICET) , Buenos Aires , Argentina
- f Faculty of Elementary and Special Education (FEEyE) , National University of Cuyo (UNCuyo) , Mendoza , Argentina
| | - Sol Esteves
- a Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation , Favaloro University , Buenos Aires , Argentina
| | - Adrián Yoris
- a Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation , Favaloro University , Buenos Aires , Argentina
- b National Scientific and Technical Research Council (CONICET) , Buenos Aires , Argentina
| | - Edinson Muñoz
- g Departamento de Lingüística y Literatura, Facultad de Humanidades , Universidad de Santiago de Chile , Santiago , Chile
| | - Lucila Reynaldo
- a Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation , Favaloro University , Buenos Aires , Argentina
| | | | - Federico Adolfi
- a Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation , Favaloro University , Buenos Aires , Argentina
| | - Facundo Manes
- a Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation , Favaloro University , Buenos Aires , Argentina
- b National Scientific and Technical Research Council (CONICET) , Buenos Aires , Argentina
- e Centre of Excellence in Cognition and its Disorders , Australian Research Council (ACR) , Sydney , Australia
- i Department of Experimental Psychology , University of South Carolina , Columbia , SC , USA
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Frontotemporal Dementia Presenting as Gambling Disorder: When a Psychiatric Condition Is the Clue to a Neurodegenerative Disease. Cogn Behav Neurol 2017. [PMID: 28632523 DOI: 10.1097/wnn.0000000000000122] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Behavioral variant frontotemporal dementia, the most common form of frontotemporal dementia, is characterized by executive dysfunction and changes in personality and behavior, sometimes with associated psychiatric disorders. We report a man who suddenly developed a gambling disorder when he was 55 years old. A year later he developed personality changes of agitation, euphoria, and disinhibition, along with binge eating and dysthymia. He did not improve on paroxetine 40 mg/day. Two years after the onset of his symptoms, he came to our clinic for evaluation. Neuropsychological testing showed deficits in cognitive control, planning, and attention. Brain magnetic resonance imaging and 18F-fluorodeoxyglucose positron emission tomography scans showed predominant frontal and temporal alterations, worse in the right hemisphere than the left. Cerebrospinal fluid analysis was not compatible with Alzheimer disease. On the basis of current criteria, we gave him a diagnosis of probable behavioral variant frontotemporal dementia presenting with a psychiatric symptom. Our findings in this unusual patient confirm the importance of close clinical monitoring in people who have a psychiatric disorder with atypical features, because the condition may mask an underlying neurodegenerative disease.
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Abstract
BACKGROUND/AIMS The issue of whether sex offenders have cognitive deficits remains controversial. The objective of this study was to compare the neuropsychological function of older adult first time sex-offenders (FTSO), who had not previously been charged with a sexual offence prior to the age of 50, to historical long-term sex offenders (HSO) and non-sex offenders (NSO). The hypotheses were (a) that FTSO would demonstrate greater deficits in executive function, decision-making, and memory compared to non-sex offenders; and (b) the HSOs would present similar neuropsychological deficits to non-sex offenders. METHOD A battery of neuropsychological measures was administered to 100 participants comprising 32 FTSOs, 36 HSOs, and 32 NSOs. RESULTS Both FTSOs and HSOs showed significant impairment on tests of executive function (including verbal fluency, trail-making, and the Hayling test of response inhibition) as well as on tests of verbal and verbal memory compared to NSOs; however, there was no difference between the two sex offender groups. CONCLUSIONS Older adult sex offenders, overall, demonstrated poorer neuropsychological performance than older adult non-sex offenders did, although there was no difference between older first-time and historical offenders. Cognitive deficits may increase the risk of sexual offending due to impaired capacity in self-regulation, planning, judgment, and inhibition. A proportion of older adult sex offenders may be harboring acquired frontal lobe pathology.
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Affiliation(s)
| | - Philip Boyce
- b Sydney Medical School , University of Sydney , Australia
| | - John Hodges
- b Sydney Medical School , University of Sydney , Australia
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20
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Abstract
The primary goal of this article is to critically discuss the syndromic overlap that exists between early behavioural variant frontotemporal dementia (bvFTD)--the most common clinical syndrome associated with frontotemporal lobar degeneration (FTLD)--and several primary psychiatric disorders. We begin by summarising the current state of knowledge regarding FTLD, including the recent discovery of FTLD-causative genetic mutations. Clinicopathological correlations in FTLD are subsequently discussed, while emphasising that clinical syndromes of FTD are dictated by the distribution of FTLD pathology in the brain. We then review a large number of cases with suspected and confirmed bvFTD that had previously been diagnosed with a primary psychiatric disorder. The clinical and neuroscientific implications of this overlap are discussed, focusing on the importance of early diagnosis for clinical and therapeutic reasons. We propose that largely due to the paucity of biomarkers for primary psychiatric disorders, and the limited use of FTLD-related biomarkers by psychiatrists at present, it is very difficult to separate patients with early bvFTD from those with primary psychiatric disorders based on clinical grounds. Furthermore, specific limitations of the Diagnostic and Statistical Manual of Mental Disorders (DSM) 5 criteria for bvFTD may inadvertently discourage recognition of bvFTD in mental health settings. Clinically, more research is needed to develop tools that allow early differentiation of bvFTD from primary psychiatric disease, as bvFTD therapies will likely be most effective in the earliest stages of disease. From a neuroscience perspective, we argue that bvFTD provides an excellent paradigm for investigating the neural basis of psychiatric disorders.
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Affiliation(s)
- Serggio C Lanata
- Department of Neurology, University of California, San Francisco, Memory and Aging Center, San Francisco, California, USA
| | - Bruce L Miller
- Department of Neurology, University of California, San Francisco, Memory and Aging Center, San Francisco, California, USA
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21
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Impulsivity, decreased social exploration, and executive dysfunction in a mouse model of frontotemporal dementia. Neurobiol Learn Mem 2016; 130:34-43. [DOI: 10.1016/j.nlm.2016.01.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 01/07/2016] [Accepted: 01/16/2016] [Indexed: 12/12/2022]
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22
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Early-onset frontotemporal dementia presenting with pathological gambling. Acta Neurol Belg 2015; 115:759-61. [PMID: 25682087 DOI: 10.1007/s13760-015-0440-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Accepted: 02/03/2015] [Indexed: 10/24/2022]
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O'Callaghan C, Bertoux M, Irish M, Shine JM, Wong S, Spiliopoulos L, Hodges JR, Hornberger M. Fair play: social norm compliance failures in behavioural variant frontotemporal dementia. Brain 2015; 139:204-16. [PMID: 26503957 DOI: 10.1093/brain/awv315] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 09/13/2015] [Indexed: 11/13/2022] Open
Abstract
Adherence to social norms is compromised in a variety of neuropsychiatric conditions. Functional neuroimaging studies have investigated social norm compliance in healthy individuals, leading to the identification of a network of fronto-subcortical regions that underpins this ability. However, there is a lack of corroborative evidence from human lesion models investigating the structural anatomy of norm compliance across this fronto-subcortical network. To address this, we developed a neuroeconomic task to investigate social norm compliance in a neurodegenerative lesion model: behavioural variant frontotemporal dementia, a condition characterized by gross social dysfunction. The task assessed norm compliance across three behaviours that are well-studied in the neuroeconomics literature: fairness, prosocial and punishing behaviours. We administered our novel version of the Ultimatum Game in 22 patients with behavioural variant frontotemporal dementia and 22 age-matched controls, to assess how decision-making behaviour was modulated in response to (i) fairness of monetary offers; and (ii) social context of monetary offers designed to produce either prosocial or punishing behaviours. Voxel-based morphometry was used to characterize patterns of grey matter atrophy associated with task performance. Acceptance rates between patients and controls were equivalent when only fairness was manipulated. However, patients were impaired in modulating their decisions in response to social contextual information. Patients' performance in the punishment condition was consistent with a reduced tendency to engage in punishment; this was associated with decreased grey matter volume in the anterior cingulate, orbitofrontal cortex, left dorsolateral prefrontal cortex and right inferior frontal gyrus. In the prosocial condition, patients' performance suggested a reduced expression of prosocial behaviour, associated with decreased grey matter in the anterior insula, lateral orbitofrontal cortex, anterior cingulate and dorsal striatum. Acceptance rates in the Ultimatum Game were also significantly related to impairments in the everyday expression of empathic concern. In conclusion, we demonstrate that compliance to basic social norms (fairness) can be maintained in behavioural variant frontotemporal dementia; however, more complex normative behaviours (prosociality, punishment) that require integration of social contextual information are disrupted in association with atrophy in key fronto-striatal regions. These results suggest that the integration of social contextual information to guide normative behaviour is uniquely impaired in behavioural variant frontotemporal dementia, and may explain other common features of the condition including gullibility and impaired empathy. Our findings also converge with previous functional neuroimaging investigations in healthy individuals and provide the first description of the structural anatomy of social norm compliance in a neurodegenerative lesion model.
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Affiliation(s)
- Claire O'Callaghan
- 1 Neuroscience Research Australia, Sydney, Australia 2 School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - Maxime Bertoux
- 3 Department of Clinical Neurosciences, Cambridge University, Cambridge, UK
| | - Muireann Irish
- 1 Neuroscience Research Australia, Sydney, Australia 4 School of Psychology, University of New South Wales, Sydney, Australia 5 ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia
| | - James M Shine
- 1 Neuroscience Research Australia, Sydney, Australia 6 School of Psychology, Stanford University, Palo Alto, California, USA
| | - Stephanie Wong
- 1 Neuroscience Research Australia, Sydney, Australia 5 ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia
| | - Leonidas Spiliopoulos
- 7 Max Planck Institute for Human Development, Centre for Adaptive Rationality, Berlin, Germany
| | - John R Hodges
- 1 Neuroscience Research Australia, Sydney, Australia 2 School of Medical Sciences, University of New South Wales, Sydney, Australia 5 ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia
| | - Michael Hornberger
- 1 Neuroscience Research Australia, Sydney, Australia 2 School of Medical Sciences, University of New South Wales, Sydney, Australia 3 Department of Clinical Neurosciences, Cambridge University, Cambridge, UK 5 ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia
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Bott NT, Radke A, Stephens ML, Kramer JH. Frontotemporal dementia: diagnosis, deficits and management. Neurodegener Dis Manag 2015; 4:439-54. [PMID: 25531687 DOI: 10.2217/nmt.14.34] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Frontotemporal dementia (FTD) is a progressive neurologic syndrome with diverse clinical presentations and attendant underlying pathologies. Psychiatric prodrome, neuropsychiatric symptoms and language difficulties are common in FTD, but the diversity of presentation raises unique diagnostic challenges that can significantly impact patient care and counsel for caregivers regarding clinical status and prognosis. While neuropsychiatric symptom measures are helpful, more sensitive assessments delineating the specific behavioral and linguistic deficits accompanying FTD are needed. Comprehensive clinical assessment in combination with evaluation of language, socio-emotional functioning, cognition and neuroimaging aid in accurate and early diagnosis and treatment planning. In what follows, we review each of the FTD syndromes, highlight current research investigating the cognitive, behavioral and socio-emotional deficits observed with this disease, address common diagnostic challenges and summarize best practices associated with management of FTD.
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Affiliation(s)
- Nicholas T Bott
- Department of Neurology, Memory & Aging Center, University of California, 675 Nelson Rising Lane, Suite 190, San Francisco, CA 94158, USA
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Abstract
As a popular form of recreational risk taking, gambling games offer a paradigm for decision neuroscience research. As an individual behavior, gambling becomes dysfunctional in a subset of the population, with debilitating consequences. Gambling disorder has been recently reconceptualized as a "behavioral addiction" in the DSM-5, based on emerging parallels with substance use disorders. Why do some individuals undergo this transition from recreational to disordered gambling? The biomedical model of problem gambling is a "brain disorder" account that posits an underlying neurobiological abnormality. This article first delineates the neural circuitry that underpins gambling-related decision making, comprising ventral striatum, ventromedial prefrontal cortex, dopaminergic midbrain, and insula, and presents evidence for pathophysiology in this circuitry in gambling disorder. These biological dispositions become translated into clinical disorder through the effects of gambling games. This influence is better articulated in a public health approach that describes the interplay between the player and the (gambling) product. Certain forms of gambling, including electronic gambling machines, appear to be overrepresented in problem gamblers. These games harness psychological features, including variable ratio schedules, near-misses, "losses disguised as wins," and the illusion of control, which modulate the core decision-making circuitry that is perturbed in gambling disorder.
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Affiliation(s)
- W Spencer Murch
- Centre for Gambling Research at UBC, Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Luke Clark
- Centre for Gambling Research at UBC, Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
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Neuropsychiatric symptoms as early manifestations of emergent dementia: Provisional diagnostic criteria for mild behavioral impairment. Alzheimers Dement 2015; 12:195-202. [PMID: 26096665 DOI: 10.1016/j.jalz.2015.05.017] [Citation(s) in RCA: 432] [Impact Index Per Article: 48.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 02/26/2015] [Accepted: 05/08/2015] [Indexed: 12/19/2022]
Abstract
Neuropsychiatric symptoms (NPS) are common in dementia and in predementia syndromes such as mild cognitive impairment (MCI). NPS in MCI confer a greater risk for conversion to dementia in comparison to MCI patients without NPS. NPS in older adults with normal cognition also confers a greater risk of cognitive decline in comparison to older adults without NPS. Mild behavioral impairment (MBI) has been proposed as a diagnostic construct aimed to identify patients with an increased risk of developing dementia, but who may or may not have cognitive symptoms. We propose criteria that include MCI in the MBI framework, in contrast to prior definitions of MBI. Although MBI and MCI can co-occur, we suggest that they are different and that both portend a higher risk of dementia. These MBI criteria extend the previous literature in this area and will serve as a template for validation of the MBI construct from epidemiologic, neurobiological, treatment, and prevention perspectives.
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Sauvaget A, Jiménez-Murcia S, Fernández-Aranda F, Fagundo AB, Moragas L, Wolz I, Veciana De Las Heras M, Granero R, Del Pino-Gutiérrez A, Baño M, Real E, Aymamí MN, Grall-Bronnec M, Menchón JM. Unexpected online gambling disorder in late-life: a case report. Front Psychol 2015; 6:655. [PMID: 26074835 PMCID: PMC4444736 DOI: 10.3389/fpsyg.2015.00655] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 05/04/2015] [Indexed: 12/03/2022] Open
Abstract
Background: The lifetime prevalence of problem or Gambling disorder (GD) in the elderly (i.e., those over 60 years old) is reported to range from 0.01 to 10.9%. Research has identified several specific risk factors and vulnerabilities in the elderly. Since the late 1990s, an increase in online GD has been observed in the youth population, whereas casinos, slot machines, and bingo seem to be the activities of choice among the elderly. Interestingly, online GD has not been described in the elderly to date. Case Description: We report an 83-year-old man who started online casino gambling from the age of 80 years, leading to debts that exceeded €30,000. He underwent a full clinical and neuropsychological assessment, without any evidence of cognitive impairment or any associated neurodegenerative disease. However, he had risk factors for GD, including adjustment disorder, stressful life events, previous offline casino GD when 50 years old, and dysfunctional personality traits. The change to online GD may have been due to his isolation, movement difficulties, and his high level of education, which facilitated his access to the Internet. Care management focused on individual cognitive-behavioral therapy. Conclusion: The prevalence of online GD may be underestimated among the elderly, and may increase among isolated old people with movement difficulties and ready access to the Internet. However, late-life GD should be considered a diagnosis of elimination, requiring a full medical, psychiatric (including suicide risk), and cognitive assessment. Specific therapeutic approaches need to be proposed and developed.
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Affiliation(s)
- Anne Sauvaget
- Addictology and Liaison Psychiatry Department, Nantes University Hospital Nantes, France ; Department of Psychiatry, University Hospital of Bellvitge-IDIBELL Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL Barcelona, Spain ; CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III Barcelona, Spain ; Department of Clinical Sciences, School of Medicine, University of Barcelona Barcelona, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL Barcelona, Spain ; CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III Barcelona, Spain ; Department of Clinical Sciences, School of Medicine, University of Barcelona Barcelona, Spain
| | - Ana B Fagundo
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL Barcelona, Spain ; CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III Barcelona, Spain
| | - Laura Moragas
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL Barcelona, Spain
| | - Ines Wolz
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL Barcelona, Spain ; CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III Barcelona, Spain
| | | | - Roser Granero
- CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III Barcelona, Spain ; Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona Barcelona, Spain
| | - Amparo Del Pino-Gutiérrez
- Department of Public Health, Mental Health and Perinatal Nursing, University School of Nursing, University of Barcelona Barcelona, Spain
| | - Marta Baño
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL Barcelona, Spain
| | - Eva Real
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL Barcelona, Spain
| | - Maria N Aymamí
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL Barcelona, Spain
| | - Marie Grall-Bronnec
- Addictology and Liaison Psychiatry Department, Nantes University Hospital Nantes, France
| | - José M Menchón
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL Barcelona, Spain ; Department of Clinical Sciences, School of Medicine, University of Barcelona Barcelona, Spain ; CIBER Salud Mental, Instituto de Salud Carlos III Barcelona, Spain
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Pompanin S, Jelcic N, Cecchin D, Cagnin A. Impulse control disorders in frontotemporal dementia: spectrum of symptoms and response to treatment. Gen Hosp Psychiatry 2014; 36:760.e5-7. [PMID: 25042130 DOI: 10.1016/j.genhosppsych.2014.06.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Revised: 06/10/2014] [Accepted: 06/11/2014] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To describe a patient with behavioral variant frontotemporal dementia (bvFTD) presenting with impulse control disorders (ICDs) which responded to fluvoxamine and topiramate. CASE REPORT A 64-year-old woman was affected by several ICDs. At disease onset, she suffered from impulsive smoking and overeating which caused a body weight increase of 20 kg in 6 months. Later on she manifested binge-eating behavior and skin-picking compulsion. Presence of progressive frontal cognitive impairment (Mini Mental State Examination 24/30) and evidence of hypoperfusion of the anterior cingulate and dorsolateral frontal cortex with brain single-photon emission computed tomography scan contributed to the diagnosis of bvFTD. Use of combination treatment with selective serotonin reuptake inhibitor drugs and topiramate improved all these symptoms. CONCLUSION This case extends the clinical phenotype of repetitive and compulsive habits in bvFTD to encompass symptoms suggestive of ICDs. It is proposed that fluvoxamine and topiramate may be considered as treatment options in these conditions.
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Affiliation(s)
- Sara Pompanin
- Department of Neurosciences: Sciences NPSRR, University of Padova, Padova, Italy
| | - Nela Jelcic
- IRCCS San Camillo Hospital Foundation, Venice, Italy
| | - Diego Cecchin
- Department of Medicine (DIMED), University of Padova, Padova, Italy
| | - Annachiara Cagnin
- Department of Neurosciences: Sciences NPSRR, University of Padova, Padova, Italy; IRCCS San Camillo Hospital Foundation, Venice, Italy.
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Fernández-Matarrubia M, Matías-Guiu J, Moreno-Ramos T, Matías-Guiu J. Demencia frontotemporal variante conductual: aproximación clínica y terapéutica. Neurologia 2014; 29:464-72. [DOI: 10.1016/j.nrl.2013.03.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 03/16/2013] [Indexed: 10/26/2022] Open
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Fernández-Matarrubia M, Matías-Guiu J, Moreno-Ramos T, Matías-Guiu J. Behavioural variant frontotemporal dementia: Clinical and therapeutic approaches. NEUROLOGÍA (ENGLISH EDITION) 2014. [DOI: 10.1016/j.nrleng.2013.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Abstract
Failure of inhibitory control is an early and consistent feature in patients suffering from frontotemporal dementia (FTD). This appears because of their pervasive ventromedial prefrontal atrophy-particularly in the orbitofrontal cortex-which has been linked to inhibitory dysfunction in studies on human and monkey lesions. However, the range of measures currently available to assess inhibitory processes in FTD is limited, and, as such, inhibitory dysfunction in FTD remains relatively underexplored. Subjective caregiver questionnaires are useful for defining disinhibition as it manifests behaviorally; however, endorsement of symptoms can vary largely across patients as it is contingent on the perceptiveness of the caregiver. The few objective neuropsychological tasks that tap directly into inhibitory functioning have potential, although they mostly rely on intact language and semantics, which can confound performance in FTD patients. An emergent possibility is to explore inhibitory functioning in FTD through nonverbal experimental tasks. Adaptation of such experimental tasks into clinical tools is a promising avenue for exploring one of the earliest behavioral features in FTD patients and concomitantly tap into their prevalent orbitofrontal cortex dysfunction. We suggest that improved characterization of early inhibitory dysfunction may facilitate more accurate diagnosis of FTD.
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Ozel-Kizil E, Sakarya A, Arica B, Haran S. A case of frontotemporal dementia with amyotrophic lateral sclerosis presenting with pathological gambling. J Clin Neurol 2013; 9:133-7. [PMID: 23626653 PMCID: PMC3633192 DOI: 10.3988/jcn.2013.9.2.133] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2011] [Revised: 02/24/2012] [Accepted: 02/24/2012] [Indexed: 12/13/2022] Open
Abstract
Background Pathological gambling (PG), which is characterized by consistent, repetitive gambling and unsuccessful quitting attempts, is classified as an impulse control disorder. PG has also been reported in patients with Parkinson's disease, frontotemporal dementia, and amyotrophic lateral sclerosis. Case Report A 53-year-old male visited the outpatient clinic due to excessive gambling and personality changes. Based on electrophysiological findings and neuropsychiatric assessment, he was diagnosed as frontotemporal dementia-amyotrophic lateral sclerosis. Conclusions This case report underlines that PG can also be seen in patients with neurological disorders involving the orbitofrontal cortex.
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Affiliation(s)
- Et Ozel-Kizil
- Department of Psychiatry, Ankara University School of Medicine, Ankara, Turkey
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Pose M, Cetkovich M, Gleichgerrcht E, Ibáñez A, Torralva T, Manes F. The overlap of symptomatic dimensions between frontotemporal dementia and several psychiatric disorders that appear in late adulthood. Int Rev Psychiatry 2013; 25:159-67. [PMID: 23611346 DOI: 10.3109/09540261.2013.769939] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Several factors make diagnosis of a possible behavioural variant of frontotemporal dementia (bvFTD) particularly challenging, especially the overlap of certain symptomatic dimensions such as apathy, disinhibition, depression, anhedonia, stereotyped behaviour, and psychosis between bvFTD and several psychiatric disorders that appear in late adulthood. We discuss the most frequent psychiatric conditions that can simulate early bvFTD symptoms, including late onset bipolar disorder, late onset schizophrenia-like psychosis, late onset depression, and attention deficit hyperactivity disorder in middle and older age.
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Money for nothing - Atrophy correlates of gambling decision making in behavioural variant frontotemporal dementia and Alzheimer's disease. NEUROIMAGE-CLINICAL 2013; 2:263-72. [PMID: 24179781 PMCID: PMC3778267 DOI: 10.1016/j.nicl.2013.01.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 01/15/2013] [Accepted: 01/28/2013] [Indexed: 11/23/2022]
Abstract
Neurodegenerative patients show often severe everyday decision making problems. Currently it is however not clear which brain atrophy regions are implicated in such decision making problems. We investigated the atrophy correlates of gambling decision making in a sample of 63 participants, including two neurodegenerative conditions (behavioural variant frontotemporal dementia — bvFTD; Alzheimer's disease — AD) as well as healthy age-matched controls. All participants were tested on the Iowa Gambling Task (IGT) and the behavioural IGT results were covaried against the T1 MRI scans of all participants to identify brain atrophy regions implicated in gambling decision making deficits. Our results showed a large variability in IGT performance for all groups with both patient groups performing especially poor on the task. Importantly, bvFTD and AD groups did not differ significantly on the behavioural performance of the IGT. However, by contrast, the atrophy gambling decision making correlates differed between bvFTD and AD, with bvFTD showing more frontal atrophy and AD showing more parietal and temporal atrophy being implicated in decision making deficits, indicating that both patient groups fail the task on different levels. Frontal (frontopolar, anterior cingulate) and parietal (retrosplenial) cortex atrophy covaried with poor performance on the IGT. Taken together, the atrophy correlates of gambling decision making show that such deficits can occur due to a failure of different neural structures, which will inform future diagnostics and treatment options to alleviate these severe everyday problems in neurodegenerative patients.
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Manes F. Psychiatric conditions that can mimic early behavioral variant frontotemporal dementia: the importance of the new diagnostic criteria. Curr Psychiatry Rep 2012; 14:450-2. [PMID: 22700066 DOI: 10.1007/s11920-012-0294-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Facundo Manes
- Institute of Cognitive Neurology, Institute of Neuroscience, Favaloro University, Pacheco de Melo 1854/60, C1126AAB, Buenos Aires, Argentina.
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Ibanez A, Cetkovich M, Petroni A, Urquina H, Baez S, Gonzalez-Gadea ML, Kamienkowski JE, Torralva T, Torrente F, Strejilevich S, Teitelbaum J, Hurtado E, Guex R, Melloni M, Lischinsky A, Sigman M, Manes F. The neural basis of decision-making and reward processing in adults with euthymic bipolar disorder or attention-deficit/hyperactivity disorder (ADHD). PLoS One 2012; 7:e37306. [PMID: 22624011 PMCID: PMC3356275 DOI: 10.1371/journal.pone.0037306] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Accepted: 04/18/2012] [Indexed: 01/26/2023] Open
Abstract
Background Attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder (BD) share DSM-IV criteria in adults and cause problems in decision-making. Nevertheless, no previous report has assessed a decision-making task that includes the examination of the neural correlates of reward and gambling in adults with ADHD and those with BD. Methodology/Principal Findings We used the Iowa gambling task (IGT), a task of rational decision-making under risk (RDMUR) and a rapid-decision gambling task (RDGT) which elicits behavioral measures as well as event-related potentials (ERPs: fERN and P3) in connection to the motivational impact of events. We did not observe between-group differences for decision-making under risk or ambiguity (RDMUR and IGT); however, there were significant differences for the ERP-assessed RDGT. Compared to controls, the ADHD group showed a pattern of impaired learning by feedback (fERN) and insensitivity to reward magnitude (P3). This ERP pattern (fERN and P3) was associated with impulsivity, hyperactivity, executive function and working memory. Compared to controls, the BD group showed fERN- and P3-enhanced responses to reward magnitude regardless of valence. This ERP pattern (fERN and P3) was associated with mood and inhibitory control. Consistent with the ERP findings, an analysis of source location revealed reduced responses of the cingulate cortex to the valence and magnitude of rewards in patients with ADHD and BD. Conclusions/Significance Our data suggest that neurophysiological (ERPs) paradigms such as the RDGT are well suited to assess subclinical decision-making processes in patients with ADHD and BD as well as for linking the cingulate cortex with action monitoring systems.
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Affiliation(s)
- Agustin Ibanez
- Laboratory of Experimental Psychology and Neuroscience, Institute of Cognitive Neurology, Favaloro University, Buenos Aires, Argentina.
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Abstract
PURPOSE OF REVIEW Neurodegenerative diseases often cause focal damage to brain structures mediating social cognition and personality, resulting in altered interpersonal communication and behavior. We review recent research describing this phenomenon in various aspects of social cognition. RECENT FINDINGS Corresponding to their pervasive socioemotional deficits, patients with frontotemporal dementia perform poorly on laboratory-based tasks including recognizing emotions, attending to salient information that guides social behavior, representing social knowledge, comprehending others' mental states, and maintaining insight to their own difficulties. Together with poor executive and regulation mechanisms, these social cognition deficits ultimately impact behavior. Patients with logopenic and nonfluent primary progressive aphasia have some deficits recognizing emotional prosody, whereas those with the semantic variant show more widespread deficits in social comprehension. Although Alzheimer's disease patients perform poorly on some social cognition tasks, this typically reflects general cognitive impairment, and their real-life social functioning is less affected than in diseases targeting frontotemporal structures. Studies in motor diseases such as Parkinson's suggest some degradation of emotion recognition and social comprehension, which should be investigated further. SUMMARY We summarize recent findings concerning perception and evaluation of socioemotional information, social knowledge storage and access, advanced information processing mechanisms, and behavioral response selection and regulation across various neurodegenerative diseases.
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Sedda A, Passoni S, Bottini G. Perseverations and non-verbal confabulations on the Rey-Osterrieth Complex Figure Test in a fronto-temporal dementia single case study. Neurocase 2012; 18:366-76. [PMID: 22136569 DOI: 10.1080/13554794.2011.608368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
We describe the case of a patient with late onset fronto-temporal dementia (FTD), who presented with typical personality changes, but also perseverative and confabulatory behaviors while performing the Rey-Osterrieth Complex Figure Test. We hypothesize that the progressive atrophy of orbitobasal, medial, and dorsolateral frontal cortices may give rise to both confabulations and perseverations in the non-verbal domain. In agreement with previous studies, reporting atypical profiles, this case report underlines the clinical heterogeneity of FTD. Authors declare that they have no conflicts of interest.
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Affiliation(s)
- A Sedda
- Psychology Department, University of Pavia, Piazza Botta 6, Pavia 27100, Italy.
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Slachevsky A, Muñoz-Neira C, Nuñez-Huasaf J, Stern TA, Blesius CR, Atri A. Late-onset cinephilia and compulsive behaviors: harbingers of frontotemporal dementia. Prim Care Companion CNS Disord 2011; 13:10f01115. [PMID: 21977365 DOI: 10.4088/pcc.10f01115] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Andrea Slachevsky
- Department of Neurological Sciences and Program of Molecular and Clinical Pharmacology, ICBM, Faculty of Medicine, University of Chile, and Cognitive Neurology and Dementia Unit, Hospital del Salvador, Santiago, Chile
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Piguet O, Hornberger M, Mioshi E, Hodges JR. Behavioural-variant frontotemporal dementia: diagnosis, clinical staging, and management. Lancet Neurol 2010; 10:162-72. [PMID: 21147039 DOI: 10.1016/s1474-4422(10)70299-4] [Citation(s) in RCA: 336] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Patients with behavioural-variant frontotemporal dementia (bvFTD) present with insidious changes in personality and interpersonal conduct that indicate progressive disintegration of the neural circuits involved in social cognition, emotion regulation, motivation, and decision making. The underlying pathological changes are heterogeneous and are characterised by various intraneuronal inclusions. Biomarkers to detect these histopathological changes in life are becoming increasingly important with the development of disease-modifying drugs. Gene mutations have been found that collectively account for around 10-20% of cases. Recently, criteria proposed for bvFTD define three levels of diagnostic certainty: possible, probable, and definite. Detailed history taking from family members to elicit behavioural features underpins the diagnostic process, with support from neuropsychological testing designed to detect impairment in decision making, emotion processing, and social cognition. Brain imaging is important for increasing the level of diagnostic certainty. A recently developed staging instrument shows much promise for monitoring patients and evaluating therapies, which at present are aimed at symptom amelioration. Carer education and support remain of paramount importance.
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Affiliation(s)
- Olivier Piguet
- Neuroscience Research Australia, Randwick, NSW, Australia
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Gleichgerrcht E, Ibáñez A, Roca M, Torralva T, Manes F. Decision-making cognition in neurodegenerative diseases. Nat Rev Neurol 2010; 6:611-23. [PMID: 21045795 DOI: 10.1038/nrneurol.2010.148] [Citation(s) in RCA: 150] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A large proportion of human social neuroscience research has focused on the issue of decision-making. Impaired decision-making is a symptomatic feature of a number of neurodegenerative diseases, but the nature of these decision-making deficits depends on the particular disease. Thus, examining the qualitative differences in decision-making impairments associated with different neurodegenerative diseases could provide valuable information regarding the underlying neural basis of decision-making. Nevertheless, few comparative reports of decision-making across patient groups exist. In this Review, we examine the neuroanatomical substrates of decision-making in relation to the neuropathological changes that occur in Alzheimer disease, frontotemporal dementia, Parkinson disease and Huntington disease. We then examine the main findings from studies of decision-making in these neurodegenerative diseases. Finally, we suggest a number of recommendations that future studies could adopt to aid our understanding of decision-making cognition.
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Affiliation(s)
- Ezequiel Gleichgerrcht
- Institute of Cognitive Neurology (INECO), Favaloro University, Castex 3293 (1425), Buenos Aires, Argentina.
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