1
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Fieldhouse JLP, van Engelen MPE, Handgraaf D, de Boer SCM, van 't Hooft JJ, Schouws SNTM, van Grootheest D, Kerssens C, Duits FH, van Harten AC, Oudega ML, Vijverberg EGB, Pijnenburg YAL. Trajectories of behavior and social cognition in behavioral variant frontotemporal dementia and primary psychiatric disorders: A call for better operationalization of socioemotional changes. Eur J Neurol 2024:e16426. [PMID: 39171655 DOI: 10.1111/ene.16426] [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: 03/28/2024] [Revised: 07/12/2024] [Accepted: 07/18/2024] [Indexed: 08/23/2024]
Abstract
BACKGROUND AND PURPOSE Behavioral variant frontotemporal dementia (bvFTD) and primary psychiatric disorders (PPD), such as mood, psychotic, and autism spectrum disorders, share similar clinical characteristics of behavior and social cognition. Better understanding of clinical progression in bvFTD and PPD is essential for adequate disease monitoring and trial design. METHODS In this longitudinal study (N = 89), patients with bvFTD and PPD with at least one follow-up assessment were included from the Social Brain Project of the Alzheimer Center Amsterdam. Behavioral change and social cognitive decline were assessed via informant-rated questionnaires (Cambridge Behavioral Inventory-Revised, Frontal Behavioral Inventory [FBI], Stereotypy Rating Inventory, Frontotemporal Dementia Rating Scale, Revised Self-Monitoring Scale [RSMS]-caregiver) and patient assessment (Ekman 60-Faces Test, RSMS-patient, Emotional Contagion Scale). Clinical trajectories (median = 1.4 years, interquartile range = 1.0-2.2) were examined using linear mixed models. In a subsample, associations with baseline serum neurofilament light (sNfL) were examined. RESULTS At baseline, behavioral and social cognitive symptoms were similar between diagnosis groups, except for poorer emotion recognition in bvFTD. Over time, behavioral symptoms worsened in bvFTD, whereas most measures remained stable and the FBI improved in PPD. Regarding social cognition, emotion recognition and caregiver-reported socioemotional sensitivity worsened in bvFTD and remained stable in PPD. Patient-reported social cognitive measures did not change over time. Higher sNfL was associated with faster behavioral change. CONCLUSIONS Trajectories of behavior and social cognition differentiate bvFTD from PPD, provided that social cognition is not patient-reported. Therefore, we stress the need to optimize longitudinal social cognitive assessment in bvFTD. sNfL may be a useful prognostic marker of behavioral progression in neuropsychiatric populations.
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Affiliation(s)
- Jay L P Fieldhouse
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Center, location Vrije Universiteit Medical Center, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
| | - Marie-Paule E van Engelen
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Center, location Vrije Universiteit Medical Center, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
| | - Dédé Handgraaf
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Center, location Vrije Universiteit Medical Center, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
| | - Sterre C M de Boer
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Center, location Vrije Universiteit Medical Center, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
| | - Jochum J van 't Hooft
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Center, location Vrije Universiteit Medical Center, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
| | - Sigfried N T M Schouws
- Department of Psychiatry, Amsterdam University Medical Center, location Vrije Universiteit Medical Center, Amsterdam, the Netherlands
- GGZ inGeest Mental Health Care, Amsterdam, the Netherlands
| | - Daniël van Grootheest
- Department of Psychiatry, Amsterdam University Medical Center, location Vrije Universiteit Medical Center, Amsterdam, the Netherlands
- GGZ inGeest Mental Health Care, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep, and Stress, Amsterdam, the Netherlands
| | - Cora Kerssens
- Department of Psychiatry, Amsterdam University Medical Center, location Vrije Universiteit Medical Center, Amsterdam, the Netherlands
- GGZ inGeest Mental Health Care, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep, and Stress, Amsterdam, the Netherlands
| | - Flora H Duits
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Center, location Vrije Universiteit Medical Center, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
| | - Argonde C van Harten
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Center, location Vrije Universiteit Medical Center, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
| | - Mardien L Oudega
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Center, location Vrije Universiteit Medical Center, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
- Department of Psychiatry, Amsterdam University Medical Center, location Vrije Universiteit Medical Center, Amsterdam, the Netherlands
- GGZ inGeest Mental Health Care, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep, and Stress, Amsterdam, the Netherlands
| | - Everard G B Vijverberg
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Center, location Vrije Universiteit Medical Center, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
| | - Yolande A L Pijnenburg
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Center, location Vrije Universiteit Medical Center, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
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2
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Fieldhouse JLP, van Paassen DN, van Engelen MPE, De Boer SCM, Hartog WL, Braak S, Schoonmade LJ, Schouws SNTM, Krudop WA, Oudega ML, Mutsaerts HJMM, Teunissen CE, Vijverberg EGB, Pijnenburg YAL. The pursuit for markers of disease progression in behavioral variant frontotemporal dementia: a scoping review to optimize outcome measures for clinical trials. Front Aging Neurosci 2024; 16:1382593. [PMID: 38784446 PMCID: PMC11112081 DOI: 10.3389/fnagi.2024.1382593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 04/16/2024] [Indexed: 05/25/2024] Open
Abstract
Behavioral variant frontotemporal dementia (bvFTD) is a neurodegenerative disorder characterized by diverse and prominent changes in behavior and personality. One of the greatest challenges in bvFTD is to capture, measure and predict its disease progression, due to clinical, pathological and genetic heterogeneity. Availability of reliable outcome measures is pivotal for future clinical trials and disease monitoring. Detection of change should be objective, clinically meaningful and easily assessed, preferably associated with a biological process. The purpose of this scoping review is to examine the status of longitudinal studies in bvFTD, evaluate current assessment tools and propose potential progression markers. A systematic literature search (in PubMed and Embase.com) was performed. Literature on disease trajectories and longitudinal validity of frequently-used measures was organized in five domains: global functioning, behavior, (social) cognition, neuroimaging and fluid biomarkers. Evaluating current longitudinal data, we propose an adaptive battery, combining a set of sensitive clinical, neuroimaging and fluid markers, adjusted for genetic and sporadic variants, for adequate detection of disease progression in bvFTD.
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Affiliation(s)
- Jay L. P. Fieldhouse
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, Netherlands
| | - Dirk N. van Paassen
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, Netherlands
| | - Marie-Paule E. van Engelen
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, Netherlands
| | - Sterre C. M. De Boer
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, Netherlands
| | - Willem L. Hartog
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, Netherlands
| | - Simon Braak
- Department of Psychiatry, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
- Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress Program, Amsterdam, Netherlands
| | | | - Sigfried N. T. M. Schouws
- Department of Psychiatry, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
- GGZ inGeest Mental Health Care, Amsterdam, Netherlands
| | - Welmoed A. Krudop
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
- GGZ inGeest Mental Health Care, Amsterdam, Netherlands
| | - Mardien L. Oudega
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, Netherlands
- Department of Psychiatry, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
- Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress Program, Amsterdam, Netherlands
- GGZ inGeest Mental Health Care, Amsterdam, Netherlands
| | - Henk J. M. M. Mutsaerts
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
| | - Charlotte E. Teunissen
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, Netherlands
- Neurochemistry Laboratory, Department of Laboratory Medicine, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
| | - Everard G. B. Vijverberg
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, Netherlands
| | - Yolande A. L. Pijnenburg
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, Netherlands
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3
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Franzen S, Nuytemans K, Bourdage R, Caramelli P, Ellajosyula R, Finger E, Illán-Gala I, Loi SM, Morhardt D, Pijnenburg Y, Rascovsky K, Williams MM, Yokoyama J, Alladi S, Broce I, Castro-Suarez S, Coleman K, de Souza LC, Dacks PA, de Boer SCM, de Leon J, Dodge S, Grasso S, Gupta V, Gupta V, Ghoshal N, Kamath V, Kumfor F, Matias-Guiu JA, Narme P, Nielsen TR, Okhuevbie D, Piña-Escudero SD, Garcia RR, Scarioni M, Slachevsky A, Suarez-Gonzalez A, Tee BL, Tsoy E, Ulugut H, Babulal GM, Onyike CU. Gaps in clinical research in frontotemporal dementia: A call for diversity and disparities-focused research. Alzheimers Dement 2023; 19:5817-5836. [PMID: 37270665 PMCID: PMC10693651 DOI: 10.1002/alz.13129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 02/06/2023] [Indexed: 06/05/2023]
Abstract
Frontotemporal dementia (FTD) is one of the leading causes of dementia before age 65 and often manifests as abnormal behavior (in behavioral variant FTD) or language impairment (in primary progressive aphasia). FTD's exact clinical presentation varies by culture, language, education, social norms, and other socioeconomic factors; current research and clinical practice, however, is mainly based on studies conducted in North America and Western Europe. Changes in diagnostic criteria and procedures as well as new or adapted cognitive tests are likely needed to take into consideration global diversity. This perspective paper by two professional interest areas of the Alzheimer's Association International Society to Advance Alzheimer's Research and Treatment examines how increasing global diversity impacts the clinical presentation, screening, assessment, and diagnosis of FTD and its treatment and care. It subsequently provides recommendations to address immediate needs to advance global FTD research and clinical practice.
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Affiliation(s)
- Sanne Franzen
- Department of Neurology and Alzheimer Center, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Karen Nuytemans
- John P. Hussman Institute for Human Genomics and Dr. John T. Macdonald Department of Human Genetics, University of Miami, Miller School of Medicine, Miami, FL
| | - Renelle Bourdage
- Department of Neurology and Alzheimer Center, Erasmus MC University Medical Center, Rotterdam, the Netherlands
- Laboratoire Mémoire Cerveau et Cognition (UR 7536), Institut de Psychologie, Université Paris Cité, Boulogne-Billancourt, France
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Research Group, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte (MG), Brazil
| | - Ratnavalli Ellajosyula
- Manipal Hospitals, Bangalore and Annasawmy Mudaliar Hospital, Bangalore, India
- Manipal Academy of Higher Education (MAHE), India
| | - Elizabeth Finger
- Parkwood Institute Research, London, Ontario, Canada
- Robarts Research Institute, University of Western Ontario, London, Ontario, Canada
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Ignacio Illán-Gala
- Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Samantha M. Loi
- Neuropsychiatry, Royal Melbourne Hospital, Parkville VIC Australia 3050
- Department of Psychiatry, University of Melbourne, Parkville VIC Australia 3052
| | - Darby Morhardt
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine
| | - Yolande Pijnenburg
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - Katya Rascovsky
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania Perelman School of Medicine
| | | | - Jennifer Yokoyama
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Suvarna Alladi
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Iris Broce
- Department of Neurosciences, UC San Diego
- Department of Neurology, UC San Francisco
| | - Sheila Castro-Suarez
- CBI en Demencias y Enfermedades Desmielinizantes del Sistema Nervioso, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
- Atlantic Senior Fellow for Equity in Brain Health at the University of California San Francisco, San Francisco, CA, 94115, USA
| | | | - Leonardo Cruz de Souza
- Department of Internal Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Sterre C. M. de Boer
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - Jessica de Leon
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, CA, USA
| | - Shana Dodge
- The Association for Frontotemporal Degeneration
| | - Stephanie Grasso
- Speech, Language and Hearing Sciences, The University of Texas at Austin
| | - Veer Gupta
- IMPACT—The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, VIC 3216, Australia
| | - Vivek Gupta
- Macquarie Medical school, Faculty of Medicine, Health and Human Sciences, Macquarie University, NSW, Australia
| | - Nupur Ghoshal
- Depts. of Neurology and Psychiatry, Knight Alzheimer Disease Research Center, Washington University School of Medicine
| | - Vidyulata Kamath
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Fiona Kumfor
- The University of Sydney, Brain & Mind Centre and the School of Psychology, Sydney, Australia
| | - Jordi A. Matias-Guiu
- Department of Neurology, Hospital Clinico San Carlos, San Carlos Institute for Health Research (IdiSSC), Universidad Complutense, Madrid, Spain
| | - Pauline Narme
- Laboratoire Mémoire Cerveau et Cognition (UR 7536), Institut de Psychologie, Université Paris Cité, Boulogne-Billancourt, France
| | - T. Rune Nielsen
- Danish Dementia Research Center, Department of Neurology, The Neuroscience Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Daniel Okhuevbie
- Department of Cell Biology and Genetics, University of Lagos, Nigeria
- Department of Comparative Biosciences, University of Wisconsin-Madison, USA
| | - Stefanie D. Piña-Escudero
- Global Brain Health Institute at the Memory and Aging Center. University of California, San Francisco, USA
| | - Ramiro Ruiz Garcia
- Instituto Nacional de Neurología y Neurocirurgía Manuel Velasco Suárez, Mexico DF, Mexico
| | - Marta Scarioni
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | - Andrea Slachevsky
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department - Intitute of Biomedical Sciences (ICBM), Neurocience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
- Memory and Neuropsychiatric Center (CMYN), Memory Unit, Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
- Servicio de Neurología, Departamento de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
| | - Aida Suarez-Gonzalez
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Boon Lead Tee
- Memory and Aging Center, University of California at San Francisco, San Francisco, CA, United States
- Department of Neurology, Dyslexia Center, University of California, San Francisco, CA, United States
- Global Brain Health Institute, University of California, San Francisco, United States
| | - Elena Tsoy
- Speech, Language and Hearing Sciences, The University of Texas at Austin
- Global Brain Health Institute, University of California San Francisco and Trinity College Dublin
| | - Hülya Ulugut
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, CA, USA
| | - Ganesh M. Babulal
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
- Institute of Public Health, Washington University in St. Louis, St. Louis, MO, USA
- Department of Psychology, Faculty of Humanities, University of Johannesburg, South Africa
- Department of Clinical Research and Leadership, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Chiadi U. Onyike
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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4
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Addition of the FTD Module to the Neuropsychiatric Inventory improves classification of frontotemporal dementia spectrum disorders. J Neurol 2023; 270:2674-2687. [PMID: 36811680 PMCID: PMC10129920 DOI: 10.1007/s00415-023-11596-3] [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: 12/19/2022] [Revised: 01/26/2023] [Accepted: 01/28/2023] [Indexed: 02/24/2023]
Abstract
Most neuropsychiatric symptoms (NPS) common in frontotemporal dementia (FTD) are currently not part of the Neuropsychiatric Inventory (NPI). We piloted an FTD Module that included eight extra items to be used in conjunction with the NPI. Caregivers of patients with behavioural variant FTD (n = 49), primary progressive aphasia (PPA; n = 52), Alzheimer's dementia (AD; n = 41), psychiatric disorders (n = 18), presymptomatic mutation carriers (n = 58) and controls (n = 58) completed the NPI and FTD Module. We investigated (concurrent and construct) validity, factor structure and internal consistency of the NPI and FTD Module. We performed group comparisons on item prevalence, mean item and total NPI and NPI with FTD Module scores, and multinomial logistic regression to determine its classification abilities. We extracted four components, together explaining 64.1% of the total variance, of which the largest indicated the underlying dimension 'frontal-behavioural symptoms'. Whilst apathy (original NPI) occurred most frequently in AD, logopenic and non-fluent variant PPA, the most common NPS in behavioural variant FTD and semantic variant PPA were loss of sympathy/empathy and poor response to social/emotional cues (part of FTD Module). Patients with primary psychiatric disorders and behavioural variant FTD showed the most severe behavioural problems on both the NPI as well as the NPI with FTD Module. The NPI with FTD Module correctly classified more FTD patients than the NPI alone. By quantifying common NPS in FTD the NPI with FTD Module has large diagnostic potential. Future studies should investigate whether it can also prove a useful addition to the NPI in therapeutic trials.
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5
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Cerami C, Perdixi E, Meli C, Marcone A, Zamboni M, Iannaccone S, Dodich A. Early Identification of Different Behavioral Phenotypes in the Behavioral Variant of Frontotemporal Dementia with the Aid of the Mini-Frontal Behavioral Inventory (mini-FBI). J Alzheimers Dis 2022; 89:299-308. [DOI: 10.3233/jad-220173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: The Frontal Behavioral Inventory (FBI) is a questionnaire designed to quantify behavioral changes in frontotemporal dementia (FTD). Literature showed heterogeneous FBI profiles in FTD versus Alzheimer’s disease (AD) with variable occurrence of positive and negative symptoms. Objective: In this study, we constructed a short FBI version (i.e., mini-FBI) with the aim to provide clinicians with a short tool for the identification of early behavioral changes in behavioral variant of FTD (bvFTD), also facilitating the differential diagnosis with AD. Methods: 40 bvFTD and 33 AD patients were enrolled. FBI items were selected based on internal consistency and exploratory factor analysis. Convergent validity of mini-FBI was also assessed. A behavioral index (i.e., B-index) representing the balance between positive and negative mini-FBI symptoms was computed in order to analyze its distribution in bvFTD through a cluster analysis and to compare performance among patient groups. Results: The final version of the mini-FBI included 12 items, showing a significant convergent validity with the Neuropsychiatric Inventory scores (rp = 0.61, p < 0.001). Cluster analysis split patients in four clusters. bvFTD were included in three different clusters characterized by prevalent positive symptoms, both positive and negative symptoms, or prevalent negative behavioral alterations, similar to a subset of AD patients. A fourth cluster included only AD patients showing no positive symptoms. Conclusion: The mini-FBI is a valuable easily administrable questionnaire able to early identify symptoms effectively contributing to the bvFTD behavioral syndrome, aiding clinician in diagnosis and management.
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Affiliation(s)
- Chiara Cerami
- IUSS Cognitive Neuroscience ICoN Center, Scuola Universitaria Superiore IUSS Pavia, Pavia, Italy
- Cognitive Computational Neuroscience Research Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Elena Perdixi
- Department of Neurology, IRCCS Humanitas Clinical and Research Center, Rozzano, Milano, Italy
| | - Claudia Meli
- Center for Neurocognitive Rehabilitation - CIMeC, University of Trento, Rovereto (TN), Italy
| | - Alessandra Marcone
- Department of Rehabilitation and Functional Recovery, San Raffaele Hospital, Milan, Italy
| | - Michele Zamboni
- Department of Rehabilitation and Functional Recovery, San Raffaele Hospital, Milan, Italy
| | - Sandro Iannaccone
- Department of Rehabilitation and Functional Recovery, San Raffaele Hospital, Milan, Italy
| | - Alessandra Dodich
- Center for Neurocognitive Rehabilitation - CIMeC, University of Trento, Rovereto (TN), Italy
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6
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Chu M, Liu L, Wang J, Liu L, Kong Y, Jing D, Xie K, Cui Y, Cui B, Zhang J, Ye H, Li J, Wang L, Rosa-Neto P, Gauthier S, Wu L. Investigating the Roles of Anterior Cingulate in Behavioral Variant Frontotemporal Dementia: A PET/MRI Study. J Alzheimers Dis 2021; 84:1771-1779. [PMID: 34719498 PMCID: PMC8764589 DOI: 10.3233/jad-215127] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background: The anterior cingulate cortex (ACC) seems to play an important role in behavioral deficits and executive dysfunctions in patients with behavioral variant frontotemporal dementia (bvFTD), while its specific and independent contribution requires clarification. Objective: To identify whether ACC abnormalities in gray matter (GM) volume and standardized uptake value ratio (SUVR) images are associated with disease severity of bvFTD, by analyzing hybrid T1 and 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET). Methods: We enrolled 21 bvFTD patients and 21 healthy controls in the study. Each subject underwent a hybrid PET/MRI study and a standardized neuropsychologic assessment battery. GM volume and SUVR are voxel-wise calculated and compared. Then we estimate the mean value inside ACC for further partial Pearson’s correlation to explore the association between GM volume/SUVR of the ACC and severity of behavioral deficit as well as executive dysfunction. Results: ACC was shown to be involved in both atrophy and hypometabolism patterns. The partial Pearson’s correlation analysis showed that the SUVR of the ACC was strongly correlated with frontal behavior inventory total score (left r = –0.85, right r = –0.85, p < 0.0001), disinhibition subscale score (left r = –0.72, p = 0.002; right = –0.75, p < 0.0001), and apathy subscale score (left = –0.87, right = –0.85, p < 0.0001). Conclusion: These findings demonstrated decreased ACC activity contributes to behavioral disturbances of both apathetic and disinhibition syndromes of bvFTD, which can be sensitively detected using 18F-FDG PET.
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Affiliation(s)
- Min Chu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Li Liu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Department of Neurology, Shenyang Fifth People Hospital, Shenyang, China
| | - Jingjuan Wang
- Department of Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Lin Liu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Department of Neurology, Second Hospital of ShanXi Medical University, Taiyuan, China
| | - Yu Kong
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Donglai Jing
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Department of Neurology, Rongcheng People's Hospital, Hebei, China
| | - Kexin Xie
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yue Cui
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Bo Cui
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jing Zhang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Hong Ye
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Junjie Li
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Lin Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Pedro Rosa-Neto
- McGill Centre for Studies in Aging, Alzheimer's Disease Research Unit, Montreal, Canada
| | - Serge Gauthier
- McGill Centre for Studies in Aging, Alzheimer's Disease Research Unit, Montreal, Canada
| | - Liyong Wu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
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7
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Guger M, Raschbacher S, Kellermair L, Vosko MR, Eggers C, Forstner T, Leitner K, Fuchs A, Fellner F, Ransmayr G. Caregiver burden in patients with behavioural variant frontotemporal dementia and non-fluent variant and semantic variant primary progressive aphasia. J Neural Transm (Vienna) 2021; 128:1623-1634. [PMID: 34282470 PMCID: PMC8528762 DOI: 10.1007/s00702-021-02378-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 07/01/2021] [Indexed: 11/30/2022]
Abstract
Studies on caregiver burden in patients with frontotemporal lobar degeneration are rare, differ methodologically and show variable results. Single center longitudinal pilot study on caregiver burden and potential risk factors in patients with behavioural variant frontotemporal dementia (bvFTD) and semantic (svPPA) and non-fluent variants (nfvPPA) primary progressive aphasia. Forty-six bvFTD, nine svPPA, and six nfvPPA patients and caring relatives were analysed for up to 2 years using the Mini-Mental State Examination as global measure for cognitive performance, Frontal Assessment Battery (frontal lobe functions), Frontal Behavioural Inventory (personality and behaviour), Neuropsychiatric Inventory (dementia-related neuropsychiatric symptoms), Barthel Index and Lawton IADL Scale (basic and instrumental activities of daily living), the Caregiver Strain Index (CSI), and in most participants also the Zarit Burden Interview (ZBI). CSI baseline sum scores were highest in bvFTD (mean ± SD 5.5 ± 3.4, median 5, IQR 6), intermediate in svPPA (2.9 ± 2.3; 3; 3.5) and low in nfvPPA (1.6 ± 2.1; 1; 2). Similar differences of caregiver burden were found using the ZBI. During follow-up, CSI and ZBI sum scores deteriorated in svPPA, not in bvFTD and nfvPPA, and correlated significantly with personality and behaviour, neuropsychiatric symptoms, caregiver age, and instrumental, but not basic activities of daily living, Mini-Mental State Examination scores or frontal lobe functions. This study reveals differences in caregiver burden in variants of frontotemporal lobar degeneration. Caregivers should be systematically asked for caregiver burden from the time of the diagnosis to provide comprehensive support in time.
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Affiliation(s)
- Michael Guger
- Department of Neurology 2, Med Campus III, Kepler University Hospital GmbH, Krankenhausstr. 9, 4021, Linz, Austria
- Medical Faculty, Johannes Kepler University, Linz, Austria
| | - Stefan Raschbacher
- Department of Neurology 2, Med Campus III, Kepler University Hospital GmbH, Krankenhausstr. 9, 4021, Linz, Austria
| | - Lukas Kellermair
- Department of Neurology 2, Med Campus III, Kepler University Hospital GmbH, Krankenhausstr. 9, 4021, Linz, Austria
- Medical Faculty, Johannes Kepler University, Linz, Austria
| | - Milan R Vosko
- Department of Neurology 2, Med Campus III, Kepler University Hospital GmbH, Krankenhausstr. 9, 4021, Linz, Austria
- Medical Faculty, Johannes Kepler University, Linz, Austria
| | - Christian Eggers
- Department of Neurology 2, Med Campus III, Kepler University Hospital GmbH, Krankenhausstr. 9, 4021, Linz, Austria
- Medical Faculty, Johannes Kepler University, Linz, Austria
| | - Thomas Forstner
- Department of Applied Systems Research and Statistics, Johannes Kepler University, Linz, Austria
| | - Karin Leitner
- Clinical and Health Psychology Unit, Med Campus III, Kepler University Hospital GmbH, Linz, Austria
| | - Alexandra Fuchs
- Clinical and Health Psychology Unit, Med Campus III, Kepler University Hospital GmbH, Linz, Austria
| | - Franz Fellner
- Medical Faculty, Johannes Kepler University, Linz, Austria
- Central Radiology Institute, Med Campus III, Kepler University Hospital GmbH, Linz, Austria
| | - Gerhard Ransmayr
- Department of Neurology 2, Med Campus III, Kepler University Hospital GmbH, Krankenhausstr. 9, 4021, Linz, Austria.
- Medical Faculty, Johannes Kepler University, Linz, Austria.
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Benussi A, Premi E, Gazzina S, Brattini C, Bonomi E, Alberici A, Jiskoot L, van Swieten JC, Sanchez-Valle R, Moreno F, Laforce R, Graff C, Synofzik M, Galimberti D, Masellis M, Tartaglia C, Rowe JB, Finger E, Vandenberghe R, de Mendonça A, Tagliavini F, Santana I, Ducharme S, Butler CR, Gerhard A, Levin J, Danek A, Otto M, Frisoni G, Ghidoni R, Sorbi S, Le Ber I, Pasquier F, Peakman G, Todd E, Bocchetta M, Rohrer JD, Borroni B. Progression of Behavioral Disturbances and Neuropsychiatric Symptoms in Patients With Genetic Frontotemporal Dementia. JAMA Netw Open 2021; 4:e2030194. [PMID: 33404617 PMCID: PMC7788468 DOI: 10.1001/jamanetworkopen.2020.30194] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
IMPORTANCE Behavioral disturbances are core features of frontotemporal dementia (FTD); however, symptom progression across the course of disease is not well characterized in genetic FTD. OBJECTIVE To investigate behavioral symptom frequency and severity and their evolution and progression in different forms of genetic FTD. DESIGN, SETTING, AND PARTICIPANTS This longitudinal cohort study, the international Genetic FTD Initiative (GENFI), was conducted from January 30, 2012, to May 31, 2019, at 23 multicenter specialist tertiary FTD research clinics in the United Kingdom, the Netherlands, Belgium, France, Spain, Portugal, Italy, Germany, Sweden, Finland, and Canada. Participants included a consecutive sample of 232 symptomatic FTD gene variation carriers comprising 115 with variations in C9orf72, 78 in GRN, and 39 in MAPT. A total of 101 carriers had at least 1 follow-up evaluation (for a total of 400 assessments). Gene variations were included only if considered pathogenetic. MAIN OUTCOMES AND MEASURES Behavioral and neuropsychiatric symptoms were assessed across disease duration and evaluated from symptom onset. Hierarchical generalized linear mixed models were used to model behavioral and neuropsychiatric measures as a function of disease duration and variation. RESULTS Of 232 patients with FTD, 115 (49.6%) had a C9orf72 expansion (median [interquartile range (IQR)] age at evaluation, 64.3 [57.5-69.7] years; 72 men [62.6%]; 115 White patients [100%]), 78 (33.6%) had a GRN variant (median [IQR] age, 63.4 [58.3-68.8] years; 40 women [51.3%]; 77 White patients [98.7%]), and 39 (16.8%) had a MAPT variant (median [IQR] age, 56.3 [49.9-62.4] years; 25 men [64.1%]; 37 White patients [94.9%]). All core behavioral symptoms, including disinhibition, apathy, loss of empathy, perseverative behavior, and hyperorality, were highly expressed in all gene variant carriers (>50% patients), with apathy being one of the most common and severe symptoms throughout the disease course (51.7%-100% of patients). Patients with MAPT variants showed the highest frequency and severity of most behavioral symptoms, particularly disinhibition (79.3%-100% of patients) and compulsive behavior (64.3%-100% of patients), compared with C9orf72 carriers (51.7%-95.8% of patients with disinhibition and 34.5%-75.0% with compulsive behavior) and GRN carriers (38.2%-100% with disinhibition and 20.6%-100% with compulsive behavior). Alongside behavioral symptoms, neuropsychiatric symptoms were very frequently reported in patients with genetic FTD: anxiety and depression were most common in GRN carriers (23.8%-100% of patients) and MAPT carriers (26.1%-77.8% of patients); hallucinations, particularly auditory and visual, were most common in C9orf72 carriers (10.3%-54.5% of patients). Most behavioral and neuropsychiatric symptoms increased in the early-intermediate phases and plateaued in the late stages of disease, except for depression, which steadily declined in C9orf72 carriers, and depression and anxiety, which surged only in the late stages in GRN carriers. CONCLUSIONS AND RELEVANCE This cohort study suggests that behavioral and neuropsychiatric disturbances differ between the common FTD gene variants and have different trajectories throughout the course of disease. These findings have crucial implications for counseling patients and caregivers and for the design of disease-modifying treatment trials in genetic FTD.
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Affiliation(s)
- Alberto Benussi
- Centre for Neurodegenerative Disorders, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Enrico Premi
- Vascular Neurology Unit, Department of Neurological and Vision Sciences, ASST Spedali Civili, Brescia, Italy
| | - Stefano Gazzina
- Neurophysiology Unit, Department of Neurological and Vision Sciences, ASST Spedali Civili, Brescia, Italy
| | - Chiara Brattini
- Centre for Neurodegenerative Disorders, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Elisa Bonomi
- Centre for Neurodegenerative Disorders, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Antonella Alberici
- Neurology Unit, Department of Neurological and Vision Sciences, ASST Spedali Civili, Brescia, Italy
| | - Lize Jiskoot
- Department of Neurology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | | | - Raquel Sanchez-Valle
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Institut d’Investigacións Biomèdiques August Pi I Sunyer, University of Barcelona, Barcelona, Spain
| | - Fermin Moreno
- Cognitive Disorders Unit, Department of Neurology, Donostia University Hospital, San Sebastian, Spain
- Neuroscience Area, Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain
| | - Robert Laforce
- Clinique Interdisciplinaire de Mémoire, Département des Sciences Neurologiques du CHU de Québec, and Faculté de Médecine, Université Laval, Québec, Canada
| | - Caroline Graff
- Center for Alzheimer Research, Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Bioclinicum, Karolinska Institutet, Solna, Sweden
- Unit for Hereditary Dementias, Theme Aging, Karolinska University Hospital, Solna, Sweden
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany
- Center for Neurodegenerative Diseases, Tübingen, Germany
| | - Daniela Galimberti
- Fondazione Ca’ Granda, IRCCS Ospedale Policlinico, Milan, Italy
- University of Milan, Centro Dino Ferrari, Milan, Italy
| | - Mario Masellis
- Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
| | - James B. Rowe
- Department of Clinical Neurosciences, University of Cambridge, United Kingdom
| | - Elizabeth Finger
- Department of Clinical Neurological Sciences, University of Western Ontario, London, Canada
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium
- Neurology Service, University Hospitals Leuven, Leuven, Belgium
- Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | | | | | - Isabel Santana
- Neurology Service, Faculty of Medicine, University Hospital of Coimbra, University of Coimbra, Coimbra, Portugal
- Center for Neuroscience and Cell Biology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Simon Ducharme
- Department of Psychiatry, McGill University Health Centre, McGill University, Montreal, Québec, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Québec, Canada
| | - Chris R. Butler
- Nuffield Department of Clinical Neurosciences, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
- Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Alexander Gerhard
- Division of Neuroscience and Experimental Psychology, Wolfson Molecular Imaging Centre, University of Manchester, Manchester, United Kingdom
- Departments of Geriatric Medicine and Nuclear Medicine, University of Duisburg-Essen, Duisburg, Germany
| | - Johannes Levin
- Department of Neurology, Ludwig-Maximilians Universität München, Munich, Germany
- German Center for Neurodegenerative Diseases, Munich, Germany
- Munich Cluster of Systems Neurology, Munich, Germany
| | - Adrian Danek
- Department of Neurology, Ludwig-Maximilians Universität München, Munich, Germany
| | - Markus Otto
- Department of Neurology, University of Ulm, Ulm, Germany
| | - Giovanni Frisoni
- IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Roberta Ghidoni
- Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Sandro Sorbi
- Department of Neurofarba, University of Florence, Florence, Italy
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Isabelle Le Ber
- Institut National de la Santé et de la Recherche Medicale (INSERM) U1127, Paris, France
- Centre de National de la Recherche Scientifique, Unité Mixte de Recherche (UMR) 7225, Paris, France
- Unité Mixte de Recherche en Santé 1127, Université Pierre et Marie Curie (Paris 06), Sorbonne Universités, Paris, France
- Institute du Cerveau et de la Moelle Epinière, Paris, France
| | - Florence Pasquier
- Inserm CHU Lille, Lille Neurosciences & Cognition UMR-S1172 Degenerative and Vascular Cognitive Disorders, Université de Lille, Lille, France
- CHU Lille, DistAlz Licend Memory Clinic, Lille, France
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, United Kingdom
| | - Georgia Peakman
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, United Kingdom
| | - Emily Todd
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, United Kingdom
| | - Martina Bocchetta
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, United Kingdom
| | - Jonathan D. Rohrer
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, United Kingdom
| | - Barbara Borroni
- Centre for Neurodegenerative Disorders, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
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Migliaccio R, Tanguy D, Bouzigues A, Sezer I, Dubois B, Le Ber I, Batrancourt B, Godefroy V, Levy R. Cognitive and behavioural inhibition deficits in neurodegenerative dementias. Cortex 2020; 131:265-283. [PMID: 32919754 PMCID: PMC7416687 DOI: 10.1016/j.cortex.2020.08.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/27/2020] [Accepted: 08/03/2020] [Indexed: 02/07/2023]
Abstract
Disinhibition, mainly caused by damage in frontotemporal brain regions, is one of the major causes of caregiver distress in neurodegenerative dementias. Behavioural inhibition deficits are usually described as a loss of social conduct and impulsivity, whereas cognitive inhibition deficits refer to impairments in the suppression of prepotent verbal responses and resistance to distractor interference. In this review, we aim to discuss inhibition deficits in neurodegenerative dementias through behavioural, cognitive, neuroanatomical and neurophysiological exploration. We also discuss impulsivity and compulsivity behaviours as related to disinhibition. We will therefore describe different tests available to assess both behavioural and cognitive disinhibition and summarise different manifestations of disinhibition across several neurodegenerative diseases (behavioural variant of frontotemporal dementia, Alzheimer's disease, Parkinson's disease, progressive supranuclear palsy, Huntington's disease). Finally, we will present the latest findings about structural, metabolic, functional, neurophysiological and also neuropathological correlates of inhibition impairments. We will briefly conclude by mentioning some of the latest pharmacological and non pharmacological treatment options available for disinhibition. Within this framework, we aim to highlight i) the current interests and limits of tests and questionnaires available to assess behavioural and cognitive inhibition in clinical practice and in clinical research; ii) the interpretation of impulsivity and compulsivity within the spectrum of inhibition deficits; and iii) the brain regions and networks involved in such behaviours.
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Affiliation(s)
- Raffaella Migliaccio
- FrontLab, INSERM U1127, Institut du cerveau, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France; Centre de Référence des Démences Rares ou Précoces, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France; Institute of Memory and Alzheimer's Disease, Centre of Excellence of Neurodegenerative Disease, Department of Neurology, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France.
| | - Delphine Tanguy
- FrontLab, INSERM U1127, Institut du cerveau, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France; Univ Rennes, Inserm, LTSI - UMR 1099, F-35000 Rennes, France
| | - Arabella Bouzigues
- FrontLab, INSERM U1127, Institut du cerveau, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | - Idil Sezer
- FrontLab, INSERM U1127, Institut du cerveau, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | - Bruno Dubois
- FrontLab, INSERM U1127, Institut du cerveau, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France; Centre de Référence des Démences Rares ou Précoces, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France; Institute of Memory and Alzheimer's Disease, Centre of Excellence of Neurodegenerative Disease, Department of Neurology, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Isabelle Le Ber
- FrontLab, INSERM U1127, Institut du cerveau, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France; Centre de Référence des Démences Rares ou Précoces, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France; Institute of Memory and Alzheimer's Disease, Centre of Excellence of Neurodegenerative Disease, Department of Neurology, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Bénédicte Batrancourt
- FrontLab, INSERM U1127, Institut du cerveau, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | - Valérie Godefroy
- FrontLab, INSERM U1127, Institut du cerveau, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | - Richard Levy
- FrontLab, INSERM U1127, Institut du cerveau, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France; Centre de Référence des Démences Rares ou Précoces, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France; Institute of Memory and Alzheimer's Disease, Centre of Excellence of Neurodegenerative Disease, Department of Neurology, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
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10
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Cosseddu M, Benussi A, Gazzina S, Alberici A, Dell'Era V, Manes M, Cristillo V, Borroni B, Padovani A. Progression of behavioural disturbances in frontotemporal dementia: a longitudinal observational study. Eur J Neurol 2019; 27:265-272. [DOI: 10.1111/ene.14071] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 08/21/2019] [Indexed: 11/29/2022]
Affiliation(s)
- M. Cosseddu
- Neurology Unit Spedali Civili of Brescia Brescia
| | - A. Benussi
- Neurology Unit Department of Clinical and Experimental Sciences University of Brescia Brescia Italy
| | - S. Gazzina
- Neurology Unit Department of Clinical and Experimental Sciences University of Brescia Brescia Italy
| | - A. Alberici
- Neurology Unit Spedali Civili of Brescia Brescia
| | - V. Dell'Era
- Neurology Unit Department of Clinical and Experimental Sciences University of Brescia Brescia Italy
| | - M. Manes
- Neurology Unit Department of Clinical and Experimental Sciences University of Brescia Brescia Italy
| | - V. Cristillo
- Neurology Unit Department of Clinical and Experimental Sciences University of Brescia Brescia Italy
| | - B. Borroni
- Neurology Unit Department of Clinical and Experimental Sciences University of Brescia Brescia Italy
| | - A. Padovani
- Neurology Unit Department of Clinical and Experimental Sciences University of Brescia Brescia Italy
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11
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Reus LM, Vijverberg EG, Tijms BM, Kate MT, Gossink F, Krudop WA, Campo MD, Teunissen CE, Barkhof F, van der Flier WM, Visser PJ, Dols A, Pijnenburg YA. Disease trajectories in behavioural variant frontotemporal dementia, primary psychiatric and other neurodegenerative disorders presenting with behavioural change. J Psychiatr Res 2018; 104:183-191. [PMID: 30103065 DOI: 10.1016/j.jpsychires.2018.07.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 07/13/2018] [Accepted: 07/31/2018] [Indexed: 12/13/2022]
Abstract
Behavioural variant frontotemporal dementia (bvFTD) is characterized by behavioural and social cognitive disturbances, while various psychiatric and neurodegenerative disorders may have similar clinical symptoms. Since neurodegenerative disorders are eventually progressive, whereas primary psychiatric disorders are not, this study aimed to investigate whether the change in clinical symptoms over time differed between groups and which biomarkers predicted rate of decline. Disease trajectories (median follow-up = 3 years) of frontal and stereotyped behaviour, general and frontal cognitive functioning, and social cognition were examined in bvFTD (n = 34), other neurodegenerative (n = 28) and primary psychiatric disorders (n = 43), all presenting with late-onset frontal lobe syndrome (45-75 years), using linear mixed models. To gain more insight in underlying pathological processes driving disease progression, we studied the association of baseline cerebrospinal fluid (CSF) (neurofilament light (NfL) and YKL-40 levels, phosphotau181 to total tau ratio) and neuroimaging markers with disease trajectories. Frontal behavioural symptoms (e.g., disinhibition, apathy) worsened over time in bvFTD, whereas they improved in psychiatric disorders and remained stable in other neurodegenerative disorders. General and frontal cognitive decline was observed in bvFTD and other neurodegenerative disorders, but not in psychiatric disorders. None of the groups showed change in stereotypy and social cognition. For all diagnostic groups, higher CSF NfL levels were associated with faster frontal cognitive decline. A modest association was observed between caudate volume and stereotyped behaviour. Tracking frontal behavioural symptoms and cognition has potential to distinguish bvFTD from other disorders. CSF NfL levels seem to be associated with decline in frontal cognitive functioning.
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Affiliation(s)
- Lianne M Reus
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdan UMC, Amsterdam, the Netherlands.
| | - Everard Gb Vijverberg
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdan UMC, Amsterdam, the Netherlands
| | - Betty M Tijms
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdan UMC, Amsterdam, the Netherlands
| | - Mara Ten Kate
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdan UMC, Amsterdam, the Netherlands
| | - Flora Gossink
- Department of Old Age Psychiatry, GGZ inGeest, Amsterdam, the Netherlands
| | - Welmoed A Krudop
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdan UMC, Amsterdam, the Netherlands; Department of Psychiatry, UMC Utrecht, Utrecht, the Netherlands
| | - Marta Del Campo
- Neurochemistry Lab and Biobank, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Charlotte E Teunissen
- Neurochemistry Lab and Biobank, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands; Institutes of Neurology and Healthcare Engineering, UCL, London, United Kingdom
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdan UMC, Amsterdam, the Netherlands
| | - Pieter Jelle Visser
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdan UMC, Amsterdam, the Netherlands; Department of Psychiatry, Maastricht University, Maastricht, the Netherlands
| | - Annemiek Dols
- Department of Old Age Psychiatry, GGZ inGeest, Amsterdam, the Netherlands
| | - Yolande Al Pijnenburg
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdan UMC, Amsterdam, the Netherlands
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12
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Bock M, Duong YN, Kim A, Allen I, Murphy J, Lomen-Hoerth C. Progression and effect of cognitive-behavioral changes in patients with amyotrophic lateral sclerosis. Neurol Clin Pract 2017; 7:488-498. [PMID: 29431172 DOI: 10.1212/cpj.0000000000000397] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background To prospectively evaluate the progression of cognitive-behavioral function in amyotrophic lateral sclerosis (ALS) and examine the association of cognitive-behavioral deficits with disease progression, patient quality of life (QOL), and caregiver burden. Methods We evaluated cognitive-behavioral function using the Amyotrophic Lateral Sclerosis Cognitive Behavioral Screen at enrollment and after 7 months in a cohort of patients with ALS. Paired t tests were used to evaluate the change in the 2 assessments. Linear regression and Kruskal-Wallis tests were applied to investigate how initial cognitive or behavioral status related to outcomes. Results The mean test-retest interval was 6.8 months (SD 1.6). Cognitive status of the study population (n = 49) overall did not change over the study period (p = 0.06) despite progression of motor weakness (p < 0.001), though small subsets of the sample demonstrate cognitive change. Patients initially classified as behaviorally normal showed increased behavioral problems over time (t = -2.8, p = 0.009). Decline in cognitive (β = -1.3, p = 0.03) and behavioral (β = -0.76, p = 0.002) status predicted increasing caregiver burden. Behavioral abnormalities predicted decline in forced vital capacity and ALS Functional Rating Scale-Revised score (p = 0.008, 0.012) in the study population and patient QOL in the most severely affected group (t = 4.3, p = 0.003). Conclusions Cognitive-behavioral change is a key aspect of disease heterogeneity in ALS. Executive function in ALS overall remains stable over 7 months as detected by an administered screening tool. However, patients may develop caregiver-reported behavioral symptoms in that time period. Screening for caregiver-reported symptoms has a particular utility in predicting future clinical decline, increased caregiver burden, and worsening patient QOL.
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Affiliation(s)
- Meredith Bock
- Departments of Neurology (MB, Y-ND, AK, JM, CL-H) and Epidemiology and Biostatistics (IA), University of California, San Francisco
| | - Y-Nhy Duong
- Departments of Neurology (MB, Y-ND, AK, JM, CL-H) and Epidemiology and Biostatistics (IA), University of California, San Francisco
| | - Anthony Kim
- Departments of Neurology (MB, Y-ND, AK, JM, CL-H) and Epidemiology and Biostatistics (IA), University of California, San Francisco
| | - Isabel Allen
- Departments of Neurology (MB, Y-ND, AK, JM, CL-H) and Epidemiology and Biostatistics (IA), University of California, San Francisco
| | - Jennifer Murphy
- Departments of Neurology (MB, Y-ND, AK, JM, CL-H) and Epidemiology and Biostatistics (IA), University of California, San Francisco
| | - Catherine Lomen-Hoerth
- Departments of Neurology (MB, Y-ND, AK, JM, CL-H) and Epidemiology and Biostatistics (IA), University of California, San Francisco
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13
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Reul S, Lohmann H, Wiendl H, Duning T, Johnen A. Can cognitive assessment really discriminate early stages of Alzheimer's and behavioural variant frontotemporal dementia at initial clinical presentation? ALZHEIMERS RESEARCH & THERAPY 2017; 9:61. [PMID: 28793933 PMCID: PMC5550986 DOI: 10.1186/s13195-017-0287-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 07/17/2017] [Indexed: 12/13/2022]
Abstract
Background Neuropsychological testing is considered crucial for differential diagnosis of Alzheimer’s disease (AD) and behavioural variant frontotemporal dementia (bvFTD). In-depth neuropsychological assessment revealed specific dysfunctions in the two dementia syndromes. However, a significant overlap of cognitive impairments exists in early disease stages. We questioned whether a standard neuropsychological assessment at initial clinical presentation can delineate patients with AD versus bvFTD. Methods In a retrospective approach, we evaluated and compared how cognitive profiles assessed at initial clinical presentation predicted the diagnosis of later verified AD (n = 43) and bvFTD (n = 26). Additionally, the neuropsychological standard domains memory, language, visuospatial skills, executive functions, praxis and social cognition were subjected to stepwise discriminant analysis to compare their differential contribution to diagnosis. Results Regardless of diagnosis, a percentage of patients presented with major deterioration in a wide range of cognitive domains when compared with age-matched normative data. Only few significant differences were detected on the group level: Patients with AD were relatively more impaired in the verbal recall, verbal recognition, figure copy, and surprisingly in the executive subdomains, set shifting and processing speed whereas bvFTD was characterised by more deficits in imitation of face postures. A combination of tests for verbal recall, imitation of limb and face postures, and figure copy showed the greatest discriminatory power. Conclusions Our results imply that the contribution of a standard neuropsychological assessment is limited for differential diagnosis of AD and bvFTD at initial presentation. In contrast to current clinical guidelines, executive functions are neither particularly nor exclusively impaired in patients with bvFTD when assessed within a standard clinical neuropsychological test battery. The significant overlap of bvFTD and AD concerning the profile of cognitive impairments questions current neuropsychological diagnostic criteria and calls for revision, regarding both the degree and the profile of cognitive deficits.
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Affiliation(s)
- Sophia Reul
- Department of Neurology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.
| | - Hubertus Lohmann
- Department of Neurology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Heinz Wiendl
- Department of Neurology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Thomas Duning
- Department of Neurology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Andreas Johnen
- Department of Neurology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
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14
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Park MH, Kim EJ, Park KW, Kwon JC, Ku BD, Han SH, Kim S, Yang DW, Na DL, Choi SH. Behavioural and neuropsychiatric disturbance in three clinical subtypes of frontotemporal dementia: A Clinical Research Center for Dementia of South Korea-FTD Study. Australas J Ageing 2017; 36:46-51. [DOI: 10.1111/ajag.12374] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Moon Ho Park
- Department of Neurology; Korea University College of Medicine and Korea University Ansan Hospital; Ansan Korea
| | - Eun-Joo Kim
- Department of Neurology; Pusan National University Hospital; Pusan National University School of Medicine and Medical Research Institute; Busan Korea
| | - Kyung Won Park
- Department of Neurology; Dong-A Medical Center; Dong-A University College of Medicine; Busan Korea
| | - Jae Cheol Kwon
- Department of Neurology; Changwon Fatima Hospital; Changwon Korea
| | - Bon D. Ku
- Department of Neurology; Catholic Kwandong University College of Medicine; Gangneung Korea
| | - Seol-Heui Han
- Department of Neurology; Konkuk University Medical Center and Konkuk University School of Medicine; Seoul Korea
| | - SangYun Kim
- Department of Neurology; Seoul National University College of Medicine and Clinical Neuroscience Center; Seoul National University Bundang Hospital; Seoul Korea
| | - Dong Won Yang
- Department of Neurology; The Catholic University of Korea College of Medicine; Seoul Korea
| | - Duk L. Na
- Department of Neurology; Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul Korea
| | - Seong Hye Choi
- Department of Neurology; Inha University School of Medicine; Incheon Korea
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15
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Suhonen NM, Hallikainen I, Hänninen T, Jokelainen J, Krüger J, Hall A, Pikkarainen M, Soininen H, Remes AM. The Modified Frontal Behavioral Inventory (FBI-mod) for Patients with Frontotemporal Lobar Degeneration, Alzheimer’s Disease, and Mild Cognitive Impairment. J Alzheimers Dis 2017; 56:1241-1251. [DOI: 10.3233/jad-160983] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Noora-Maria Suhonen
- Medical Research Center, Oulu University Hospital, Oulu, Finland
- Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
| | - Ilona Hallikainen
- Institute of Clinical Medicine - Neurology, University of Eastern Finland, Kuopio, Finland
| | - Tuomo Hänninen
- Department of Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Jari Jokelainen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Unit of Primary Health Care, Oulu University Hospital, Oulu, Finland
| | - Johanna Krüger
- Medical Research Center, Oulu University Hospital, Oulu, Finland
| | - Anette Hall
- Institute of Clinical Medicine - Neurology, University of Eastern Finland, Kuopio, Finland
| | - Maria Pikkarainen
- Institute of Clinical Medicine - Neurology, University of Eastern Finland, Kuopio, Finland
| | - Hilkka Soininen
- Institute of Clinical Medicine - Neurology, University of Eastern Finland, Kuopio, Finland
- Department of Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Anne M. Remes
- Medical Research Center, Oulu University Hospital, Oulu, Finland
- Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
- Institute of Clinical Medicine - Neurology, University of Eastern Finland, Kuopio, Finland
- Department of Neurology, Kuopio University Hospital, Kuopio, Finland
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16
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Shinagawa S, Catindig JA, Block NR, Miller BL, Rankin KP. When a Little Knowledge Can Be Dangerous: False-Positive Diagnosis of Behavioral Variant Frontotemporal Dementia among Community Clinicians. Dement Geriatr Cogn Disord 2016; 41:99-108. [PMID: 26741499 PMCID: PMC4835218 DOI: 10.1159/000438454] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/08/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Accurate diagnosis of behavioral variant frontotemporal dementia (bvFTD) is important as patients' behavioral symptoms have profound implications for their families and communities. Since the diagnosis of bvFTD derives from behavioral features, accurate identification of patients can be difficult for non-specialists. Concrete rates of diagnostic accuracy among non-specialists are unavailable. METHODS To examine the accuracy of community clinicians' diagnoses of bvFTD and to identify patient characteristics leading to misdiagnosis, we reviewed the charts and referral letters of 3,578 patients who were seen at our specialized center. Referral diagnosis and reasons, manifesting symptoms, demographic data, Mini-Mental State Examination score, Clinical Dementia Rating score and Neuropsychiatric Inventory score were extracted. RESULTS 60% of patients assigned a single diagnosis of bvFTD by community clinicians did not have bvFTD according to specialists. Compared to specialist-confirmed bvFTD patients, false bvFTD patients were more likely to be depressed and to be non-Caucasian, showed less euphoria, apathy, disinhibition and abnormal eating behaviors, had milder disease severity and better overall cognition. bvFTD was mentioned by referring clinicians in 86% of specialist-confirmed bvFTD cases, but missed cases were called Alzheimer's, Parkinson's or Huntington's disease, or progressive aphasia. CONCLUSION These results revealed a widespread lack of familiarity with core diagnostic symptoms among non-specialists and suggest that community clinicians require specialized diagnostic support before providing a definitive diagnosis of bvFTD.
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Affiliation(s)
- Shunichiro Shinagawa
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, Calif., USA,Department of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan
| | - Joseree Ann Catindig
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, Calif., USA,Department of Neurology and Psychiatry, University of Santo Tomas, Manila, Philippines
| | - Nikolas R. Block
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, Calif., USA
| | - Bruce L. Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, Calif., USA
| | - Katherine P. Rankin
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, Calif., USA
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17
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Boutoleau-Bretonnière C, Evrard C, Hardouin JB, Rocher L, Charriau T, Etcharry-Bouyx F, Auriacombe S, Richard-Mornas A, Lebert F, Pasquier F, Sauvaget A, Bulteau S, Vercelletto M, Derkinderen P, Bretonnière C, Thomas-Antérion C. DAPHNE: A New Tool for the Assessment of the Behavioral Variant of Frontotemporal Dementia. Dement Geriatr Cogn Dis Extra 2015; 5:503-16. [PMID: 26955383 PMCID: PMC4777961 DOI: 10.1159/000440859] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The diagnosis of behavioral variant of frontotemporal dementia (bvFTD) relies primarily on clinical features and remains challenging. The specificity of the recently revised criteria can be disappointing, justifying development of new clinical tools. OBJECTIVE We produced a behavioral inventory named DAPHNE. This scale (adapted from Rascovsky's criteria) explores six domains: disinhibition, apathy, perseverations, hyperorality, personal neglect and loss of empathy. It is composed of ten items (five answer categories). The aim was (1) to assess the validity and reliability of DAPHNE and (2) to evaluate its contribution in differentiating patients. METHODS Two scores were computed: DAPHNE-6 (screening) from the six domains and DAPHNE-40 (diagnosis) from the ten items. Reliability and reproducibility were assessed. External validity was studied with the Frontal Behavioral Inventory (FBI) and the Frontotemporal Behavioral Scale (FBS). Finally, the diagnostic performance of DAPHNE was compared to revised criteria, FBI and FBS. RESULTS DAPHNE was administered to the caregivers of 89 patients, 36 with bvFTD, 22 with Alzheimer's disease, 15 with progressive supranuclear palsy and 16 with bipolar disorder. Reliability and reproducibility were excellent, as was external validity. DAPHNE-6 allowed bvFTD diagnosis (score ≥4) with a sensitivity of 92%, while DAPHNE-40 (score ≥15) had a specificity of 92%. CONCLUSION We demonstrate excellent psychometric features for DAPHNE. This quick tool could help for both diagnosing and screening bvFTD.
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Affiliation(s)
- Claire Boutoleau-Bretonnière
- CHU Nantes, Centre Mémoire Ressource et Recherche, Département de Neurologie, Université de Nantes, France
- INSERM CIC 04, Université de Nantes, France
- Laboratoire d'Etudes des Mécanismes Cognitifs, EA 3082, Université Lyon 2, Bron, Lyon, France
| | - Christelle Evrard
- CHU Nantes, Centre Mémoire Ressource et Recherche, Département de Neurologie, Université de Nantes, France
- INSERM CIC 04, Université de Nantes, France
| | - Jean Benoît Hardouin
- EA 4275, Biostatistics, Pharmacoepidemiology and Human Sciences Research Team, Université de Nantes, France
- CHU Nantes, Département de Méthodologie et Biostatistiques, Université de Nantes, Nantes, France
| | - Laëtitia Rocher
- CHU Nantes, Centre Mémoire Ressource et Recherche, Département de Neurologie, Université de Nantes, France
- INSERM CIC 04, Université de Nantes, France
| | - Tiphaine Charriau
- CHU Nantes, Centre Mémoire Ressource et Recherche, Département de Neurologie, Université de Nantes, France
- INSERM CIC 04, Université de Nantes, France
| | | | - Sophie Auriacombe
- Centre Mémoire Ressource et Recherche, Département de Neurologie, CHU Bordeaux, Bordeaux, Lyon, France
| | | | - Florence Lebert
- Centre Mémoire Ressource et Recherche, Département de Neurologie, CHU Lille, Lille, Lyon, France
| | - Florence Pasquier
- Centre Mémoire Ressource et Recherche, Département de Neurologie, CHU Lille, Lille, Lyon, France
| | - Anne Sauvaget
- CAPPA Jacques Prévert Unité ECT-TMS-Liaison, UIC 18 ‘Addictions Comportementales et Troubles de l'Humeur Complexes', Service d'Addictologie et Psychiatrie de Liaison, CHU Nantes, Université de Nantes, Nantes, France
| | - Samuel Bulteau
- CAPPA Jacques Prévert Unité ECT-TMS-Liaison, UIC 18 ‘Addictions Comportementales et Troubles de l'Humeur Complexes', Service d'Addictologie et Psychiatrie de Liaison, CHU Nantes, Université de Nantes, Nantes, France
| | - Martine Vercelletto
- CHU Nantes, Centre Mémoire Ressource et Recherche, Département de Neurologie, Université de Nantes, France
- INSERM CIC 04, Université de Nantes, France
| | - Pascal Derkinderen
- CHU Nantes, Centre Mémoire Ressource et Recherche, Département de Neurologie, Université de Nantes, France
- INSERM, UMR 913, Université de Nantes, Nantes, France
| | - Cédric Bretonnière
- EA3826, Thérapeutiques Cliniques et Expérimentales des Infections, UFR Médecine, Université de Nantes, Nantes, France
| | - Catherine Thomas-Antérion
- Laboratoire d'Etudes des Mécanismes Cognitifs, EA 3082, Université Lyon 2, Bron, Lyon, France
- Plein-Ciel, Lyon, France
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