Autonomic dysregulation in frontotemporal dementia: Table 1

Iodice, Valeria; Daveson, Naomi; Kiernan, Matthew C.; Piguet, Olivier; Hodges, John R.

doi:10.1136/jnnp-2014-309424

Cited by 37 publications

(43 citation statements)

References 9 publications

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“…In particular, bvFTD has been associated with abnormal autonomic reactivity to affectively charged stimuli,18, 19, 20, 21, 22 alterations of resting skin conductance and heart rate variability,23, 24 and abnormal brain‐heart coupling,24, 25 while nfvPPA has been associated with reduced pupil responses to arousing stimuli 20, 26. Taken together, these findings are consistent with the known targeting of core cerebral autonomic fronto‐cingulo‐insular circuitry in bvFTD and nfvPPA 27, 28, 29, 30. svPPA has also been associated with deficits in afferent interoceptive signal processing 20, 26, 31, 32.…”

Section: Introductionsupporting

confidence: 72%

Cardiac responses to viewing facial emotion differentiate frontotemporal dementias

Marshall

Hardy

Allen

et al. 2018

Ann Clin Transl Neurol

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ObjectiveTo establish proof‐of‐principle for the use of heart rate responses as objective measures of degraded emotional reactivity across the frontotemporal dementia spectrum, and to demonstrate specific relationships between cardiac autonomic responses and anatomical patterns of neurodegeneration.MethodsThirty‐two patients representing all major frontotemporal dementia syndromes and 19 healthy older controls performed an emotion recognition task, viewing dynamic, naturalistic videos of facial emotions while ECG was recorded. Cardiac reactivity was indexed as the increase in interbeat interval at the onset of facial emotions. Gray matter associations of emotional reactivity were assessed using voxel‐based morphometry of patients’ brain MR images.ResultsRelative to healthy controls, all patient groups had impaired emotion identification, whereas cardiac reactivity was attenuated in those groups with predominant fronto‐insular atrophy (behavioral variant frontotemporal dementia and nonfluent primary progressive aphasia), but preserved in syndromes focused on the anterior temporal lobes (right temporal variant frontotemporal dementia and semantic variant primary progressive aphasia). Impaired cardiac reactivity correlated with gray matter atrophy in a fronto‐cingulo‐insular network that overlapped correlates of cognitive emotion processing.InterpretationAutonomic indices of emotional reactivity dissociate from emotion categorization ability, stratifying frontotemporal dementia syndromes and showing promise as novel biomarkers. Attenuated cardiac responses to the emotions of others suggest a core pathophysiological mechanism for emotional blunting and degraded interpersonal reactivity in these diseases.

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Section: Introductionsupporting

confidence: 72%

Cardiac responses to viewing facial emotion differentiate frontotemporal dementias

Marshall

Hardy

Allen

et al. 2018

Ann Clin Transl Neurol

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“…[3] The neurotransmitters involved in these regions are acetylcholine, adrenaline, and noradrenaline which can be impaired quite early in patients with FTD and AD. [34] The literature on early autonomic dysfunction seen in FTD and AD is scarce.…”

Section: Introductionmentioning

confidence: 99%

Autonomic dysfunction: A comparative study of patients with Alzheimer’s and frontotemporal dementia – A pilot study

Issac

Chandra

Gupta

et al. 2017

Journal of Neurosciences in Rural Practice

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Introduction:In frontotemporal dementia (FTD) and Alzheimer's disease (AD), central autonomic structures get affected early. An insight into autonomic functions in these patients is likely to be of diagnostic importance and thus help in prognosticating and also probably explain unexplained sudden death in some of these patients.Objectives:The objective of this study is to identify autonomic dysfunction prevailing in patients. Then, if there is dysfunction, is the pattern same or different in these two conditions. And if different it will serve as an additional biomarker for specific diagnosis.Patients and Methods:There were 25 patients and 25 controls and six patients and three controls in AD and FTD groups, respectively. The participants who were recruited were assessed for heart rate variability and conventional cardiac autonomic function testing. The parameters were analyzed using LabChart version 7 software and compared with control population using appropriate statistical methods using SPSS version 22 software.Results:The mean overall total power was low in the FTD group (P < 0.001), and there was significant reduction in the standard deviation of normal-to-normal intervals and root mean square of successive differences (P < 0.001) with elevated sympathovagal balance in the FTD group (P = 0.04). Patients with AD also showed sympathetic dominance, but there was in addition parasympathetic suppression unlike in the FTD group.Conclusion:This study reveals autonomic dysfunction in patients with FTD and AD. Both conditions show sympathetic dominance, probably consecutive to the involvement of central autonomic regulatory structures as a shared domain. It remains to be confirmed if these findings are the cause or effect of neurodegeneration and might open up newer territories of research based on the causal role of neurotransmitters in these regions and thus lead to novel therapeutic options such as yoga. The presence of parasympathetic suppression in AD in addition helps differentiate these two conditions.

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“…32 Many of these brain regions also undergo pathologic changes in bvFTD, 32,34 potentially disrupting reward feedback between these centers and the hypothalamus, leading to changes in eating behavior. The hypothalamus is also involved in a number of other functions including pain, temperature regulation, 30 and sleep, 35 all of which are dysregulated in bvFTD, reinforcing the pivotal role for the hypothalamus underlying bvFTD symptomatology.…”

mentioning

confidence: 99%

“…Autonomic dysregulation, which is associated with altered responses to hunger and satiety, 29 has been found to be increased in bvFTD. 30,31 In addition, the hypothalamus has functional projections to the striatum, thalamus, brainstem, orbitofrontal cortex, middle and posterior cingulum, and temporal brain regions. 32 Recent animal studies have also shown that the lateral hypothalamus connects to the reward centers in the ventral tegmental area, which may mediate sucrose preference.…”

mentioning

confidence: 99%

Eating behavior in frontotemporal dementia

et al. 2015

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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).

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Autonomic dysregulation in frontotemporal dementia: Table 1

Cited by 37 publications

References 9 publications

Cardiac responses to viewing facial emotion differentiate frontotemporal dementias

Cardiac responses to viewing facial emotion differentiate frontotemporal dementias

Autonomic dysfunction: A comparative study of patients with Alzheimer’s and frontotemporal dementia – A pilot study

Eating behavior in frontotemporal dementia

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