Objective: To contrast the relationships of hormonal eating peptides and hypothalamic volumes to eating behavior and metabolic changes (body mass index [BMI]) in behavioral variant frontotemporal dementia (bvFTD) and semantic variant primary progressive aphasia (svPPA).Methods: Seventy-five patients with dementia (19 bvFTD, 26 svPPA, and 30 Alzheimer disease dementia) and 23 controls underwent fasting blood analyses of leptin, ghrelin, cholecystokinin, peptide tyrosine tyrosine (PYY), and agouti-related peptide (AgRP) levels. On brain MRI anterior, posterior, and total hypothalamic volumes were measured. Relationships between endocrine measures, hypothalamic volumes, eating behaviors, and BMI were investigated.Results: Levels of AgRP were higher in patients with bvFTD (69 6 89 pg/mL) and svPPA (62 6 81 pg/mL) compared with controls (23 6 19 pg/mL, p , 0.01). No differences were found for leptin, oxytocin, cholecystokinin, ghrelin, and PYY levels. Patients with bvFTD and svPPA had higher scores on questionnaires measuring eating behaviors. Atrophy of the posterior and total hypothalamus was observed in the bvFTD group only. Linear regression modeling revealed that leptin and AgRP levels predicted BMI. Conclusion:Eating abnormalities are multifactorial in FTD. In bvFTD, they are in part related to hypothalamic degeneration, with potential disintegration of the network connections between the hypothalamus and orbitofrontal cortex/reward pathways. In svPPA, although hypothalamic volumes are preserved, this group experiences elevated AgRP levels similar to bvFTD, which predicts BMI in both groups. This finding highlights the potential key role of AgRP in eating and metabolic changes and provides a potential target for treatment to modify disease progression. Alterations in eating behavior are one of the diagnostic criteria for behavioral variant frontotemporal dementia (bvFTD).

Technological advancements have provided militaries with the possibility to enhance human performance and to provide soldiers with better warfighting capabilities. Though these technologies hold significant potential, their use is not without cost to the individual. This paper explores the complexities associated with using human cognitive enhancements in the military, focusing on how the purpose and context of these technologies could potentially undermine a soldier’s ability to say no to these interventions. We focus on cognitive enhancements and their ability to also enhance a soldier’s autonomy (i.e., autonomy-enhancing technologies). Through this lens, we explore situations that could potentially compel a soldier to accept such technologies and how this acceptance could impact rights to individual autonomy and informed consent within the military. In this examination, we highlight the contextual elements of vulnerability—institutional and differential vulnerability. In addition, we focus on scenarios in which a soldier’s right to say no to such enhancements can be diminished given the special nature of their work and the significance of making better moral decisions. We propose that though in some situations, a soldier may be compelled to accept said enhancements; with their right to say no diminished, it is not a blanket rule, and safeguards ought to be in place to ensure that autonomy and informed consent are not overridden.

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