Neurodegenerative and psychiatric overlap in frontotemporal lobar degeneration: a case of familial frontotemporal dementia presenting with catatonia

Abstract

The behavioral variant of frontotemporal dementia (FTD) begins with psychiatric symptoms, including changes in personal conduct and/or interpersonal behavior. Prior to developing cognitive impairment, differentiating FTD from primary psychiatric disorders, like schizophrenia, can be challenging. This paper presents a case of traumatic brain injury with subsequent depression and catatonia. Initial response to electroconvulsive therapy and lorazepam suggested primarily psychiatric pathology. Subsequent symptom progression, reduced treatment response, and detailed family history evaluation led to the diagnosis of familial FTD with C9ORF72 mutation. This case highlights that familial FTD can present with depression with suicidal tendencies and catatonia, and that the responsiveness of these behavioral manifestations to standard therapies can change over time.

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

“…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.…”

“…but these were not pathologically examined. Interestingly, among such reports, a study identified the abnormal expansion of the C9ORF72 gene . It has been pointed out that there is a relatively strict correlation between C9ORF72 expansion (and also some other gene mutations) and the neuropathological change in FTLD‐TDP .…”

“…Some of these symptoms are linked to frontal dysfunction, and the diagnostic criteria for catatonia and bvFTD partly overlap. Indeed, there are several reports of bvFTD cases that showed the catatonic syndrome . However, due to the lack of pathological examinations in these previous reports, the relation between bvFTD and catatonia is still unknown.…”

Differentiating Frontotemporal Dementia From Catatonia: A Complex Neuropsychiatric Challenge

“…4 We report a case with a complex differential diagnosis between persistent residual catatonia symptoms and bvFTD, and we review the approach to this neuropsychiatric challenge. 2,3 In addition, catatonia can also be a presenting symptom of bvFTD.…”

Acamprosate Complements Ill-Sustained Response of ECT in Catatonic Frontotemporal Dementia

“…Cardinal catatonic features commonly overlap with advanced dementia [9]. Case reports of this composite presentation abound in the literature [10,11]. Even iatrogenic cases, due to the use of anti-dementia drug donepezil, were also reported [12].…”