Bipolar Disorder Among Patients Diagnosed With Frontotemporal Dementia

Mendez, Mario F.; Parand, Leila; Akhlaghipour, Golnoush

doi:10.1176/appi.neuropsych.20010003

Cited by 25 publications

(34 citation statements)

References 78 publications

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“…For instance, some individuals with late-onset BD that seemed to have bvFTD actually developed a nonprogressive dementia that mimics bvFTD. 23 The same situation was described in four patients with BD that developed a bvFTD-like syndrome without clinical or neuroimaging progression, 57 in a patient whose abnormalities in the frontal lobe improved after treatment with lithium, 58 and in a patient with BD that presented with a relapsingremitting course of bvFTD. 59 This subgroup of individuals have been referred to as nonprogressive or phenocopy cases and they present a more benign course of bvFTD, with more autonomy in daily life, lower neuropsychological impairments and none or mild changes in neuroimaging.…”

Section: Clinical Factorsmentioning

confidence: 62%

Bipolar disorder and frontotemporal dementia: A systematic review

Meller

Patel

Duarte

et al. 2021

Acta Psychiatr Scand

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Objectives: To detail the biological, clinical and neurocognitive characteristics differentiating bipolar disorder (BD) from frontotemporal dementia (FTD) and to investigate whether BD is a risk factor for FTD.Methods: A total of 16 studies were included in this systematic review. Five studies described biological and/or neurocognitive characteristics between patients with BD and FTD, and 11 studies investigated whether BD was a risk factor for FTD.Results: Individuals with FTD presented higher levels of serum neurofilament light chain, greater grey matter reduction in frontal, parietal and temporal lobes, and increased slow wave oscillations in channels F3, F4, T3, T5, T4 and T6 within an electroencephalogram (EEG), relative to individuals with BD. Patients with FTD presented greater deficits in executive function and theory of mind compared to patients with BD in a euthymic state, and more deficits in verbal fluency compared to patients with BD in a current mood episode. Patients with BD in a current mood episode showed greater impairment in attention, working memory, verbal memory and executive function relative to individuals with FTD. In addition, retrospective studies showed that 10.2%-11.6% of patients with behavioural variant FTD (bvFTD) had a preceding history of BD. Conclusion:Biological and neurocognitive characteristics help to distinguish between BD and FTD, and it may help to reach a more precise diagnosis. In addition, individuals with BD are at higher risk of developing FTD. More studies are needed to identify the predictors of the conversion between BD to FTD.

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Section: Clinical Factorsmentioning

confidence: 62%

Bipolar disorder and frontotemporal dementia: A systematic review

Meller

Patel

Duarte

et al. 2021

Acta Psychiatr Scand

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“…It has been suggested that "although the lifelong BD may go onto develop bvFTD, it is late-onset BD that carries the most significant risk for developing bvFTD" (30); however, the present study has been focused precisely on those patients with "lifelong BD, " thus including only patients classified as EO-OABD. Our approach allows us to characterize BD patients after a long progression of the disease and is motivated by the fact that EO-OABD patients constitute a population that will continue to increase.…”

Section: Implications Of the Resultsmentioning

confidence: 99%

“…On the opposite direction, associations between bvFTD and previous psychiatric diagnosis are equally complex. The retrospective study of Mendez et al (30) revealed that 10.2% of bvFTD patients had a previous diagnosis of BD; a deeper analysis of their histories confirmed a BD diagnosis in 11 patients (8%), among whom 3 patients (2.1%) had non-progressive bvFTD while the remaining 8 patients (5.8%) fulfilled the criteria for progressive bvFTD, concluding that the relationship between bvFTD and BD may be rather heterogeneous (30). We did not identify a previous history of BD in our bvFTD sample.…”

Section: Implications Of the Resultsmentioning

confidence: 99%

“…Likewise, in bvFTD the probability of receiving an erroneous diagnosis of psychiatric disease such as BD is significantly higher than in other neurodegenerative disorders (29). A retrospective study based on the psychiatric history of 137 patients with bvFTD found that 10.2% of patients had a previous history of BD, which is significantly higher than the prevalence in the general population (2.6%) (30). Moreover, a shared genetic pre-disposition between BD and FTLD has been considered due to evidence of mutations in the C9ORF72 gene in a BD patient that evolve to FTD (22) and in a family that included both BD and DFT diagnosis (31).…”

Section: Introductionmentioning

confidence: 99%

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Exploring Signatures of Neurodegeneration in Early-Onset Older-Age Bipolar Disorder and Behavioral Variant Frontotemporal Dementia

et al. 2021

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Introduction: Older-age bipolar disorder (OABD) may involve neurocognitive decline and behavioral disturbances that could share features with the behavioral variant of frontotemporal dementia (bvFTD), making the differential diagnosis difficult in cases of suspected dementia.Objective: To compare the neuropsychological profile, brain morphometry, and structural connectivity patterns between patients diagnosed with bvFTD, patients classified as OABD with an early onset of the disease (EO-OABD), and healthy controls (HC).Methods: bvFTD patients (n = 25, age: 66 ± 7, female: 64%, disease duration: 6 ± 4 years), EO-OABD patients (n = 17, age: 65 ± 9, female: 71%, disease duration: 38 ± 8 years), and HC (n = 28, age: 62 ± 7, female: 64%) were evaluated through neuropsychological tests concerning attention, memory, executive function, praxis, and language. Brain morphometry was analyzed through surface-based morphometry (SBM), while structural brain connectivity was assessed through diffusion tensor imaging (DTI).Results: Both bvFTD and EO-OABD patients showed lower performance in neuropsychological tests of attention, verbal fluency, working memory, verbal memory, and praxis than HC. Comparisons between EO-OABD and bvFTD showed differences limited to cognitive flexibility delayed recall and intrusion errors in the memory test. SBM analysis demonstrated that several frontal, temporal, and parietal regions were altered in both bvFTD and EO-OABD compared to HC. In contrast, comparisons between bvFTD and EO-OABD evidenced differences exclusively in the right temporal pole and the left entorhinal cortex. DTI analysis showed alterations in association and projection fibers in both EO-OABD and bvFTD patients compared to HC. Commissural fibers were found to be particularly affected in EO-OABD. The middle cerebellar peduncle and the pontine crossing tract were exclusively altered in bvFTD. There were no significant differences in DTI analysis between EO-OABD and bvFTD.Discussion: EO-OABD and bvFTD may share an overlap in cognitive, brain morphometry, and structural connectivity profiles that could reflect common underlying mechanisms, even though the etiology of each disease can be different and multifactorial.

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“…Another issue that warrants consideration when interpreting the neurocognitive heterogeneity observed among bipolar individuals is the fact that some cases of late-onset BD (LOBD) may be behavioral manifestations of other conditions that mimic the disorder. LOBD, which is associated with more severe cognitive deficits (Samamé, Martino, & Strejilevich, 2013;Schouws et al, 2009) and a possible progressive course, has been proposed to be different from the 'primary' and most prevalent forms of the disorder as its etiology may be related to vascular illness or early manifestations of neurodegenerative diseases (Mendez, Parand, & Akhlaghipour, 2020;Subramaniam, Dennis, & Byrne, 2007). As evident, both illness-related processes and other clinical factors (e.g.…”

Section: Discussionmentioning

confidence: 99%

The long-term course of cognition in bipolar disorder: a systematic review and meta-analysis of patient-control differences in test-score changes

et al. 2021

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Neuropsychological impairment represents a key aspect of bipolar disorder (BD) that is evident even in early-course patients and is a strong predictor of functional outcomes among those affected. Previous meta-analyses of longitudinal studies suggest that BD-related cognitive deficits may not progress along the course of the disorder. However, short test-retest periods were used in most primary studies and comparisons with healthy controls were limited. The aim of this review was to synthesize the findings of research reports comparing long-term neurocognitive trajectories between BD patients and healthy individuals. PubMed, PsycINFO, and Scopus databases were searched from inception through July 2021. Publications were considered for inclusion if they reported cognitive test scores of BD patients and healthy controls at two different time points, with a minimum test-retest interval of 5 years. Fifteen studies compared the long-term course of cognition in BD patients with that of healthy controls. Ten of these were included in the quantitative analysis and involved 540 BD patients and 644 healthy individuals (mean follow-up period: 8.9 years). Patient-control effect sizes (standardized mean differences) were calculated for test-score changes in 24 neuropsychological variables and combined by means of meta-analytic procedures. No significant differences were found between patients and controls regarding long-term cognitive outcomes. These findings are consistent with previous shorter-term longitudinal meta-analyses and do not provide evidence for progressive cognitive deterioration in most bipolar individuals. Future studies should address the longitudinal course of cognition in different subgroups of BD patients and its prognostic and therapeutic value.

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Bipolar Disorder Among Patients Diagnosed With Frontotemporal Dementia

Abstract: Objective: Previous studies have documented manic and hypomanic symptoms in behavioral variant frontotemporal dementia (bvFTD), suggesting a relationship between bipolar disorder and bvFTD.

Cited by 25 publications

References 78 publications

Bipolar disorder and frontotemporal dementia: A systematic review

Bipolar disorder and frontotemporal dementia: A systematic review

Exploring Signatures of Neurodegeneration in Early-Onset Older-Age Bipolar Disorder and Behavioral Variant Frontotemporal Dementia

The long-term course of cognition in bipolar disorder: a systematic review and meta-analysis of patient-control differences in test-score changes

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