The authors performed a systematic review and meta-analysis of studies evaluating the affective component of the cerebellar cognitive affective syndrome. Depressive and anxiety symptoms and personality changes were more frequent in patients with spinocerebellar ataxia. Patients with cerebellar lesions were more likely to have depression, deficits in the ability to experience emotions, and behavioral difficulties. A meta-analysis revealed modestly higher scores on the Hamilton Depression Rating Scale (HAM-D) among patients with cerebellar disease. This review highlights the need for cohort studies using noncerebellar comparison groups, more sensitive measures, and appropriate-sized populations with isolated cerebellar lesions to thoroughly assess the affective component of the cerebellar cognitive affective syndrome.

Discovery of disease age-of-onset modifiers is important for clinical trials and drug design. Zhang et al. perform a genome-wide analysis of epigenetic functional polymorphisms and identify an association between the C6orf10/LOC101929163 locus and age of FTD/ALS onset. The risk allele may be associated with a pro-inflammatory state in the brain.

Patients with mild-to-moderate traumatic brain injury (TBI) (N=69) were compared with age-, gender-, and education-matched healthy control group subjects (N=79) on performance of neuropsychological tests at one and 2 years following injury, and informant-rated functional abilities. All subjects were assessed for the presence of the Apolipoprotein E-epsilon4 (APOE-epsilon4) allele and rated for "mild cognitive impairment" (MCI) or dementia. Traumatic brain injury patients were no different from the comparison group on measures of cognition or functional impairment. Traumatic brain injury was not associated with higher rates of amnestic mild cognitive impairment or dementia, and APOE-epsilon4 was not associated with cognition.

Objective: To replicate a previous finding that the trajectory of the Neuropsychiatric Inventory (NPI) shifts in the sixth year of behavioural variant frontotemporal dementia (bvFTD). We evaluated longitudinal tracking with both the Frontal Behavioural Inventory (FBI) and NPI, comparing bvFTD against other dementias. Methods: Chart reviews over two to five years for patients with bvFTD (n = 30), primary progressive aphasia (PPA, n = 13) and Alzheimer's disease (AD, n = 118) at an urban Canadian tertiary clinic specializing in dementia. Linear regressions of the longitudinal data tested predictors of annualized rates of change (ROC) in NPI and FBI total and subscales for apathy and disinhibition among dementia groups. Results: The mode of the overall sample for the most advanced duration of illness observed was 5 years, with the median at 7 years. We did not find a crescendo-decrescendo pattern in scores although, for bvFTD and AD, high initial scores correlated with ensuing downward ROCs on the NPI and FBI. Educational level showed an influence on disinhibition ROCs. The FBI was no more revealing than the NPI for apathy and disinhibition scores in these dementias. Conclusions: A cognitive reserve effect on behavioural disturbance was supported but it may take longer than our 4 years of observing the clinical sample to record inflection points in the behavioural and psychiatric symptoms seen in bvFTD. The current data only imply that both apathy and disinhibition will diminish over the course of dementia.RÉSUMÉ: Trajectoire des troubles du comportement dans différents types de démences. Objectif: Le but de l'étude était de reproduire les constatations antérieures concernant les changements de trajectoire notés à l'Inventaire neuropsychiatrique (INP) au cours de la sixième année d'évolution de la variante comportementale de la démence fronto-temporale (vcDFT). Nous avons examiné le suivi longitudinal de patients effectué au moyen de l'Inventaire du comportement frontal (ICF) et de l'INP et comparé les résultats de ces tests dans la vcDFT par rapport aux autres démences. Méthode: Nous avons revu les dossiers de patients atteints de vcDFT (n = 30), d'aphasie progressive primaire (APP, n = 13) et de maladie d'Alzheimer (MA, n = 118) fréquentant une clinique de soins tertiaires d'un centre urbain canadien spécialisé dans la démence. Nous avons examiné les facteurs de prédiction des taux annualisés de changement (TAC) dans ces différents groupes de patients au moyen de l'analyse de régression linéaire des données longitudinales de l'INP et de l'ICF global ainsi que des sous échelles pour l'apathie et la désinhibition. Résultats: La valeur modale de l'échantillon total pour la durée la plus longue de la maladie observée était de 5 ans et la médiane était de 7 ans. Nous n'avons pas constaté de patron en crescendo-décrescendo dans les scores, bien que pour la vcDFT et la MA des scores initiaux élevés étaient corrélés à un TAC à la baisse à l'INP et à l'ICF. Le niveau de scolarité avait une influence sur le TAC d...

This case emphasizes the need to consider bupropion's abuse potential when prescribing it to older adults with risk factors for substance abuse.