Treatment approaches to symptoms associated with frontotemporal degeneration

Chow, Tiffany W.

doi:10.1007/s11920-005-0040-5

Cited by 28 publications

(22 citation statements)

References 49 publications

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“…Other authors have also described apathy as a very common change in FTD [19,40] . In the NPI, apathy includes lack of interest, lethargy, social and emotional withdrawal and reduced speech output.…”

Section: Discussionmentioning

confidence: 96%

Behavioral Disturbances in the Course of Frontotemporal Dementia

Diehl‐Schmid¹,

Pohl²,

Perneczky³

et al. 2006

Dement Geriatr Cogn Disord

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Background: Behavioral disturbances are prominent in frontotemporal dementia (FTD), and their occurrence has been the topic of several investigations. Nonetheless, the prevalence and severity of behavioral disturbances of patients with FTD in different degrees of dementia severity have rarely been studied. Objective: The aim of this study was to assess and compare the prevalence and severity of behavioral disturbances in patients with mild FTD and in patients with moderate/severe dementia. Methods: We included 21 outpatients with mild FTD [Clinical Dementia Rating (CDR) = 1] and 19 patients with moderate or severe dementia (CDR = 2 or 3) in this study. Behavioral disturbances were assessed using the Neuropsychiatric Inventory (NPI). Results: We found a statistically significant difference in the total NPI scores between patients with mild FTD and patients with moderate or severe FTD, the latter scoring higher. Apathy was the most prevalent symptom in both patient groups (90.5 and 100%). Except appetite and eating disturbance, which appeared in 77.8% of the patients with moderate/severe dementia, all other symptoms were clearly less common (<50%). Conclusion: The results highlight the variability of behavioral disturbances in mild and moderate/severe stages of FTD.

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Section: Discussionmentioning

confidence: 96%

Behavioral Disturbances in the Course of Frontotemporal Dementia

Diehl‐Schmid¹,

Pohl²,

Perneczky³

et al. 2006

Dement Geriatr Cogn Disord

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“…A few clinical trials, as well as prospective and retrospective case series have been published using various pharmacological agents in patients with FTD (Chow 2005;Huey et al 2006;Freedman 2007). Conclusions from these studies become more relevant to PPA as the disorder progresses and behavioral manifestations become more prominent.…”

Section: Treatmentmentioning

confidence: 99%

A review on primary progressive aphasia

Léger

Johnson²

2008

NDT

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Primary progressive aphasia (PPA) is a neurodegenerative disease of insidious onset presenting with progressive isolated loss of language function, without signifi cant impairment in other cognitive domains. Current diagnostic criteria require the language dysfunction to remain isolated for at least two years, and to remain the salient feature as the disease progresses, usually to involve other domains such as behavior, executive functions, and judgment. Although PPA in its early stages can usually be differentiated from probable Alzheimer's disease (PRAD) and the behavioral variant of frontotemporal lobar degeneration by the absence of signifi cant changes in memory and behavior, and the preservation of activities daily living, progression of the disease often leads to defi cits more consistent with the latter. Underlying etiologies remain heterogeneous: the neuropathological characteristics associated with frontotemporal lobar degeneration, cortocobasal degeneration, and motor neuron disease are usually found. There is a strong genetic susceptibility with affl iction of fi rst-degree relatives with similar disease in up to 40 to 50% in some series. Pathogenic mutations in genes coding for the proteins tau and progranulin have been isolated. These are leading to a better understanding of the neuropathological mechanisms and hopefully targeted disease-modifying therapy. Current therapy is limited to improving mood symptoms and targeting behavior changes as they develop. Referral to specialized centers where speech therapy, counseling, and education for both patient and caregiver are available may be helpful.

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“…In summary, there is no published data showing evidence of neuroprotection or recovery of function for any of the agents tested and weak evidence of improvement of behavioral symptoms with the use of certain psychiatric medications [33]. Autopsy, imaging and cerbrospinal fluid studies suggest deficiencies in the serotonergic neurotransmitter system in FTD and FTLD [33,36]. Interestingly, several of the clinical symptoms of FTD (e.g., appetite changes and apathy) can also be observed with serotonergic dysfunction.…”

Section: Challengesmentioning

confidence: 99%

“…Interestingly, several of the clinical symptoms of FTD (e.g., appetite changes and apathy) can also be observed with serotonergic dysfunction. There is some evidence of dopaminergic abnormalities in FTD as well [33,36] but the cholinergic system appears relatively intact (especially compared with Alzheimer's disease) [33,36]. Accordingly, although there is variation in clinical practice (e.g., some physicians place FTD patients on cholinesterase inhibitors and memantine), there is no current standard-of-care treatment that all patients with FTD are given.…”

Section: Challengesmentioning

confidence: 99%