Relation between frontal lobe symptoms and dementia severity within and across diagnostic dementia categories

Abstract

In FTD patients, frontal lobe symptoms were severe in the mild, moderate and severe dementia stages although the nature of frontal lobe symptoms depended on disease severity. AD and DLB patients displayed more frontal lobe symptoms in the advanced disease stages as compared to disease onset, suggesting gradual frontal lobe involvement as the disease progresses. The nature of frontal lobe symptoms related to dementia severity differed between AD, DLB and FTD patients, suggesting different patterns of frontal lobe involvement. Last but not the least, these data point to the potential diagnostic value of behavioural observation of frontal lobe symptoms for (differential) dementia diagnosis, especially at the earliest disease stages. These findings await confirmation through a prospective, longitudinal study.

Psychosis associated behavioral and psychological signs and symptoms in mild cognitive impairment and Alzheimer's dementia

“…The MFS is a validated clinical and behavioral assessment scale that measures frontal lobe features and reliably discriminates frontotemporal dementia (FTD) from AD patients with a sensitivity and specificity of almost 90% and with good inter-and intra-rater reliability (Aries et al, 2010;De Deyn et al, 2005). According to the instructions for administration and scoring, the MFS was obtained by summating scores in a standardized fashion on 10 items.…”

Differentiation of frontotemporal dementia from dementia with Lewy bodies using FP-CIT SPECT

“…Furthermore, DLB can present with prominent behavioural symptoms,13 a dysexecutive syndrome14 and primitive reflexes,15 making it difficult at times to distinguish it from FTD clinically.…”

Neuropsychiatric Features of Frontal Lobe Dysfunction in Autopsy-Confirmed Patients with Lewy Bodies and “Pure” Alzheimer Disease

“…Compared to AD, DLB has been characterized by a relatively high prevalence of hallucinations, delusions, anxiety, anhedonia, and loss of energy occurring in earlier stages of disease (5) based on the Mini-Mental State Examination (MMSE) (6). The retrospective nature of these findings limited the inferences that could be made; however, similar results were obtained from prospective studies of neuropsychiatric changes in personality traits (7, 8) arising from DLB. On the Blessed Dementia Scale (9) (BDS), caregivers of DLB patients were more likely than AD caregivers to endorse behaviors such as diminished emotional responsiveness, apathy, purposeless hyperactivity, and relinquished hobbies subsumed under a factor of “passivity” despite noting similar levels of irritability and disinhibition (8).…”

“…A series of studies (7, 10) examined the relationship between DLB and behaviors common to frontal lobe damage. Using a measure previously shown to differentiate frontotemporal dementia from AD [Middelheim Frontality Score (MFS) (11)], investigators found no difference in clinically diagnosed DLB and AD patients in the frequency of frontal lobe behaviors when divided by dementia severity.…”

“…Aries et al (7) found that for both diagnostic groups with dementia stage based on the Global Deterioration Scale (12), the group with severe dementia had more frontal lobe behaviors on the 10-item MFS than the group with mild dementia; however, they found no significant differences between mild and moderate stages. The MFS samples a variety of behaviors that include disinhibition, as well as aspontaneity and emotional bluntness, characteristics often associated with apathy.…”