Differentiating Frontotemporal Dementia From Catatonia: A Complex Neuropsychiatric Challenge

Ducharme, Simon; Dickerson, Bradford C.; Larvie, Mykol; Price, Bruce H.

doi:10.1176/appi.neuropsych.14070157

Cited by 18 publications

(8 citation statements)

References 9 publications

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“…30 Indeed, a number of catatonic symptoms may overlap with those of the behavioral variant of FTD. 31 Catatonia has also been described as a manifestation of FTD. 32 In our sample, the diagnostic distribution was similar in responders and non-responders.…”

Section: Discussionmentioning

confidence: 99%

Clinical features and predictors of non-response in severe catatonic patients treated with electroconvulsive therapy

Tripodi

Barbuti

Novi

et al. 2021

International Journal of Psychiatry in Clinical Practice

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To explore the demographic and clinical features of severe catatonic patients, comparing responders and non-responders to ECT in order to detect possible predictors of non-response. METHODSThis naturalistic study included 59 catatonic inpatients with a diagnosis of mood disorder according to DSM-IV-TR criteria. All patients were treated with bilateral ECT and evaluated before and after ECT course. The response to ECT was defined as a Clinical Global Impression (Improvement subscale) rating 1 "very much improved" or 2 "much improved". Clinical variables were compared between responders and non-responders; logistic regression was used to predict the probability of non-response, with regard to the symptoms presented by the patients. RESULTSThe response rate was 83.1%. Non-responders (n=10) to ECT showed neurological comorbidities, treatments with dopamine agonists and anticholinergic drugs, waxy flexibility, and echophenomena more frequently than respondents (n = 49). Echophenomena resulted a significant predictor of nonresponse in the multivariate analysis. CONCLUSIONIn line with previous reports, ECT resulted effective in the vast majority of severe catatonic patients.The association between ECT resistant catatonia and neurological comorbidity, use of dopamineagonist and anticholinergic medications is consistent with the hypothesis that ECT is more effective in "top-down" than in "bottom-up" variant of catatonia.

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Section: Discussionmentioning

confidence: 99%

Clinical features and predictors of non-response in severe catatonic patients treated with electroconvulsive therapy

Tripodi

Barbuti

Novi

et al. 2021

International Journal of Psychiatry in Clinical Practice

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“…Additionally, the association between bvFTD and FTLD‐TDP type C has not been shown, so this case would be atypical in that regard. Several cases of clinical FTD with catatonic syndrome have been reported . but these were not pathologically examined.…”

Section: Discussionmentioning

confidence: 99%

Frontotemporal dementia with trans‐activation response DNA‐binding protein 43 presenting with catatonic syndrome

et al. 2017

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Catatonia is a clinical syndrome characterized by symptoms such as immobility, mutism, stupor, stereotypy, echophenomena, catalepsy, automatic obedience, posturing, negativism, gegenhalten and ambitendency. This syndrome occurs mostly in mood disorder and schizophrenic patients, and is related to neuronal dysfunction involving the frontal lobe. Some cases of frontotemporal dementia (FTD) with catatonia have been reported, but these cases were not examined by autopsy. Here, we report on a FTD case which showed catatonia after the first episode of brief psychotic disorder. At the age of 58, the patient had a sudden onset of disorganized behavior and meaningless speech. Psychotropic drugs were effective for catatonic symptoms. However, after remission apathy, hyperorality, socially inappropriate behavior, hoarding, and an instinctive grasp reaction appeared and persisted. Brain MRI showed significant atrophy of the bilateral fronto-temporal lobes. A neuropathological examination revealed extensive trans-activation response DNA-binding protein 43 (TDP-43) positive neurocytoplasmic inclusions and dystrophic neurites in the brain, including the cerebral cortex, basal ganglia, and brainstem. Pathological diagnosis was frontotemporal lobar degeneration (FTLD) with TDP-43 (FTLD-TDP) type C, which was also confirmed by the band pattern of C-terminal fragments of TDP-43 on western blotting of sarkosyl-insoluble fractions extracted from the frozen brain. Dysfunction of the thalamus, globus pallidus, supplementary motor area, amygdala and cingulate cortex have been said to be related to the catatonic syndrome. In this case, these areas were affected, showing abnormal TDP-43-positive structures. Further studies are expected to confirm further clinical - pathological correlations to FTLD.

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“…10 case report, authors reported catatonia in psychiatric disorders as being more frequently characterized by a fluctuating trend and usually responding to Lorazepam. In contrast, when catatonia was present in bvFTD, progressive and irreversible deterioration were more common [41].…”

Section: Clinical Characteristics Orienting Differential Diagnosismentioning

confidence: 95%

“…Catatonia, a clinical presentation classically associated with SCZ, is nowadays considered a specifier applicable to different psychiatric and neurological disorders (DSM-5) and could be described as a manifestation in FTD patients. Some symptoms such as stereotypy, echophenomena, mutism, and perseveration arise both in bvFTD and in catatonia [39][40][41][42]. Moreover, some case series reported catatonia as the first clinical presentation in FTD patients [43,44].…”

Section: Clinical Characteristics Orienting Differential Diagnosismentioning

confidence: 99%

Crossing Borders Between Frontotemporal Dementia and Psychiatric Disorders: An Updated Overview

Vismara

Cirnigliaro

Piccoli

et al. 2020

JAD

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Frontotemporal dementia (FTD) includes a group of neurocognitive syndromes, clinically characterized by altered behaviors, impairment of language proficiency, and altered executive functioning. FTD is one of the most frequently observed forms of dementia in the elderly population and the most common in presenile age. As for other subtypes of dementia, FTD incidence is constantly on the rise due to the steadily increasing age of the population, and its recognition is now becoming a determinant for clinicians. FTD and psychiatric disorders can overlap in terms of clinical presentations by sharing a common genetic predisposition and neuropathological mechanism in some cases. Nonetheless, this association is often unclear and underestimated.Since its first reports, research into FTD has constantly grown, with the identification of recent findings related to its neuropathology, genetic, clinical, and therapeutic issues. Literature is thriving on this topic, with numerous research articles published in recent years. In the present review, we aimed to provide an updated description of the clinical manifestations that link and potentially confound the diagnosis of FTD and psychiatric disorders in order to improve their differential diagnosis and early detection. In particular, we systematically reviewed the literature, considering articles specifically focused on the behavioral variant FTD, published after 2015 on the Pubmed database.

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Differentiating Frontotemporal Dementia From Catatonia: A Complex Neuropsychiatric Challenge

Cited by 18 publications

References 9 publications

Clinical features and predictors of non-response in severe catatonic patients treated with electroconvulsive therapy

Clinical features and predictors of non-response in severe catatonic patients treated with electroconvulsive therapy

Frontotemporal dementia with trans‐activation response DNA‐binding protein 43 presenting with catatonic syndrome

Crossing Borders Between Frontotemporal Dementia and Psychiatric Disorders: An Updated Overview

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