Prospective Evaluation of Behavioral Scales in the Behavioral Variant of Frontotemporal Dementia

Boutoleau‐Bretonnière, Claire; Lebouvier, Thibaud; Volteau, Christelle; Jaulin, Philippe; Lacomblez, Lucette; Damier, Philippe; Thomas‐Antérion, Catherine; Vercelletto, Martine

doi:10.1159/000341784

Cited by 18 publications

(16 citation statements)

References 25 publications

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“…For patients with suspected AD, mild disease stages were moreover assumed only when presenting with a Mini Mental State Examination (MMSE) score >20 [ 22 , 23 ]. In case of suspected bvFTD, disease progression was additionally estimated with the Frontal Behavioral Inventory (FBI), a caregiver report used to determine severity of behavioural changes in bvFTD [ 24 , 25 ]. Early and mild stages were assumed for scores between 25 and 30 points in accordance with the test manual [ 24 ].…”

Section: Methodsmentioning

confidence: 99%

Can cognitive assessment really discriminate early stages of Alzheimer’s and behavioural variant frontotemporal dementia at initial clinical presentation?

et al. 2017

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BackgroundNeuropsychological testing is considered crucial for differential diagnosis of Alzheimer’s disease (AD) and behavioural variant frontotemporal dementia (bvFTD). In-depth neuropsychological assessment revealed specific dysfunctions in the two dementia syndromes. However, a significant overlap of cognitive impairments exists in early disease stages. We questioned whether a standard neuropsychological assessment at initial clinical presentation can delineate patients with AD versus bvFTD.MethodsIn a retrospective approach, we evaluated and compared how cognitive profiles assessed at initial clinical presentation predicted the diagnosis of later verified AD (n = 43) and bvFTD (n = 26). Additionally, the neuropsychological standard domains memory, language, visuospatial skills, executive functions, praxis and social cognition were subjected to stepwise discriminant analysis to compare their differential contribution to diagnosis.ResultsRegardless of diagnosis, a percentage of patients presented with major deterioration in a wide range of cognitive domains when compared with age-matched normative data. Only few significant differences were detected on the group level: Patients with AD were relatively more impaired in the verbal recall, verbal recognition, figure copy, and surprisingly in the executive subdomains, set shifting and processing speed whereas bvFTD was characterised by more deficits in imitation of face postures. A combination of tests for verbal recall, imitation of limb and face postures, and figure copy showed the greatest discriminatory power.ConclusionsOur results imply that the contribution of a standard neuropsychological assessment is limited for differential diagnosis of AD and bvFTD at initial presentation. In contrast to current clinical guidelines, executive functions are neither particularly nor exclusively impaired in patients with bvFTD when assessed within a standard clinical neuropsychological test battery. The significant overlap of bvFTD and AD concerning the profile of cognitive impairments questions current neuropsychological diagnostic criteria and calls for revision, regarding both the degree and the profile of cognitive deficits.

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Section: Methodsmentioning

confidence: 99%

Can cognitive assessment really discriminate early stages of Alzheimer’s and behavioural variant frontotemporal dementia at initial clinical presentation?

et al. 2017

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“…Some studies have differentiated only two subtypes of FTD . Other studies have investigated only cognitive function or psychometric properties between some subtypes of FTD and other dementia.…”

Section: Introductionmentioning

confidence: 99%

Behavioural and neuropsychiatric disturbance in three clinical subtypes of frontotemporal dementia: A Clinical Research Center for Dementia of South Korea‐FTD Study

et al. 2017

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“…Negative symptoms decreased in psychiatric cases, potentially related to treatment. Previous studies have shown that increased FBI positive symptoms at the initial visit have a relatively high potential to discriminate bvFTD from psychiatric diagnoses, (Boutoleau-Bretonniere et al, 2012;Dols et al, 2016;. Conversely, the distinctive trajectory for the FBI in bvFTD, psychiatric and other neurodegenerative disorders was predominantly driven by negative symptoms rather than positive symptoms.…”

Section: Discussionmentioning

confidence: 87%

“…A strength of this study is that diagnosis took place with both a neurologist, psychiatrist and neuropsychologist, minimizing the chance on misdiagnoses. Additionally, the sample size of the current study was relatively high compared to former longitudinal studies on social cognition or behaviour in bvFTD, (Boutoleau-Bretonniere et al, 2012;Kumfor et al, 2014;O'Connor et al, 2016). Another strength of our study is the use of behavioural and social cognitive instruments, whereas other longitudinal studies in bvFTD have mainly used general dementia rating instruments, such as the MMSE and Clinical Dementia Rating (CDR), thereby only appreciating cognitive decline in FTD -while social cognitive and behavioural abnormalities are core features of bvFTD, (Josephs et al, 2011;Smits et al, 2015).…”

Section: Discussionmentioning

confidence: 98%

“…The present study aimed to investigate whether the change in behavioural, cognitive and social cognitive symptoms over time differed between diagnostic groups, and which biomarkers predicted rate of decline. Most prospective studies in bvFTD examined cognitive decline, (Boutoleau-Bretonniere et al, 2012;O'Connor et al, 2016;Smits et al, 2015;Tan et al, 2013), but not the progression of behavioural and social cognitive symptoms (Kumfor et al, 2014). The only study so far focussing on these measures has shown that bvFTD patients decline more rapidly on emotion recognition compared to AD patients (Kumfor et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

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Disease trajectories in behavioural variant frontotemporal dementia, primary psychiatric and other neurodegenerative disorders presenting with behavioural change

Reus

Vijverberg

Tijms

et al. 2018

Journal of Psychiatric Research

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Behavioural variant frontotemporal dementia (bvFTD) is characterized by behavioural and social cognitive disturbances, while various psychiatric and neurodegenerative disorders may have similar clinical symptoms. Since neurodegenerative disorders are eventually progressive, whereas primary psychiatric disorders are not, this study aimed to investigate whether the change in clinical symptoms over time differed between groups and which biomarkers predicted rate of decline. Disease trajectories (median follow-up = 3 years) of frontal and stereotyped behaviour, general and frontal cognitive functioning, and social cognition were examined in bvFTD (n = 34), other neurodegenerative (n = 28) and primary psychiatric disorders (n = 43), all presenting with late-onset frontal lobe syndrome (45-75 years), using linear mixed models. To gain more insight in underlying pathological processes driving disease progression, we studied the association of baseline cerebrospinal fluid (CSF) (neurofilament light (NfL) and YKL-40 levels, phosphotau to total tau ratio) and neuroimaging markers with disease trajectories. Frontal behavioural symptoms (e.g., disinhibition, apathy) worsened over time in bvFTD, whereas they improved in psychiatric disorders and remained stable in other neurodegenerative disorders. General and frontal cognitive decline was observed in bvFTD and other neurodegenerative disorders, but not in psychiatric disorders. None of the groups showed change in stereotypy and social cognition. For all diagnostic groups, higher CSF NfL levels were associated with faster frontal cognitive decline. A modest association was observed between caudate volume and stereotyped behaviour. Tracking frontal behavioural symptoms and cognition has potential to distinguish bvFTD from other disorders. CSF NfL levels seem to be associated with decline in frontal cognitive functioning.

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Prospective Evaluation of Behavioral Scales in the Behavioral Variant of Frontotemporal Dementia

Cited by 18 publications

References 25 publications

Can cognitive assessment really discriminate early stages of Alzheimer’s and behavioural variant frontotemporal dementia at initial clinical presentation?

Can cognitive assessment really discriminate early stages of Alzheimer’s and behavioural variant frontotemporal dementia at initial clinical presentation?

Behavioural and neuropsychiatric disturbance in three clinical subtypes of frontotemporal dementia: A Clinical Research Center for Dementia of South Korea‐FTD Study

Disease trajectories in behavioural variant frontotemporal dementia, primary psychiatric and other neurodegenerative disorders presenting with behavioural change

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