Demographic, neurological and behavioural characteristics and brain perfusion SPECT in frontal variant of frontotemporal dementia
- PMID: 17071924
- DOI: 10.1093/brain/awl288
Demographic, neurological and behavioural characteristics and brain perfusion SPECT in frontal variant of frontotemporal dementia
Abstract
We conducted a French multicentric cross-sectional study to describe in detail the demographic, neurological and behavioural characteristics of the frontal variant of frontotemporal dementia (fvFTD) and to characterize the pattern of brain perfusion SPECT in comparison to a healthy control group. A total of 68 fvFTD patients had technetium-99m-ECD brain perfusion SPECT at inclusion, 61 of which also underwent an in-depth evaluation including 70 items assessing behaviour, language and affect/emotion at onset and at inclusion. The mean age-at-onset was 60.4 +/- 7.8 years (35-75). Twenty-six per cent of the patients were older than 65 at onset. A positive familial history consistent with an autosomal dominant inheritance was found in 18% of the patients. At onset, the behavioural profile was predominantly inert in 25% of the patients, disinhibited in 18% and mixed in others. The behavioural features progressed to predominantly mixed or inert forms. Although, inertia was associated with predominant medial frontal and cingulate hypoperfusion, and patients with disinhibition exhibited predominant ventromedial prefrontal and temporal hypoperfusion, there were no major clinical differences between disinhibited and inert patients. Forty-five per cent of the deceased patients survived <6 years (short survival), and 34% of the patients survived >8 years (long survival). This shows that the final outcome of fvFTD is highly variable. No clinical factors predictive of short or long survival were identified. Unexpected, however, was the finding that brainstem hypoperfusion distinguished patients with a short survival from patients with long survival. In conclusion, this study shows that fvFTD is clinically a rather homogeneous entity. It also provides evidence that different behavioural presentations at onset are related to different anatomical localizations of degenerative damage. Finally, it demonstrates the prognostic value of brainstem hypoperfusion in a subgroup of patients with a short survival.
Similar articles
-
Phenotype variability in progranulin mutation carriers: a clinical, neuropsychological, imaging and genetic study.Brain. 2008 Mar;131(Pt 3):732-46. doi: 10.1093/brain/awn012. Epub 2008 Feb 1. Brain. 2008. PMID: 18245784
-
Frontotemporal dementia in Oman: cognitive behavioural profile and neuroimaging characteristics; a prospective hospital-based study.J Neurol Sci. 2007 Sep 15;260(1-2):167-74. doi: 10.1016/j.jns.2007.04.050. Epub 2007 Jun 4. J Neurol Sci. 2007. PMID: 17544447
-
The FTLD-modified Clinical Dementia Rating scale is a reliable tool for defining disease severity in frontotemporal lobar degeneration: evidence from a brain SPECT study.Eur J Neurol. 2010 May;17(5):703-7. doi: 10.1111/j.1468-1331.2009.02911.x. Epub 2009 Dec 29. Eur J Neurol. 2010. PMID: 20050899
-
Comparative cognitive neuropsychological studies of frontal lobe function: implications for therapeutic strategies in frontal variant frontotemporal dementia.Dement Geriatr Cogn Disord. 1999;10 Suppl 1:15-28. doi: 10.1159/000051207. Dement Geriatr Cogn Disord. 1999. PMID: 10436335 Review.
-
[Frontotemporal dementia: a review].Encephale. 2007 Dec;33(6):933-40. doi: 10.1016/j.encep.2006.12.001. Epub 2007 Sep 6. Encephale. 2007. PMID: 18789785 Review. French.
Cited by
-
The impact of histone post-translational modifications in neurodegenerative diseases.Biochim Biophys Acta Mol Basis Dis. 2019 Aug 1;1865(8):1982-1991. doi: 10.1016/j.bbadis.2018.10.019. Epub 2018 Oct 20. Biochim Biophys Acta Mol Basis Dis. 2019. PMID: 30352259 Free PMC article. Review.
-
Distinct anatomical subtypes of the behavioural variant of frontotemporal dementia: a cluster analysis study.Brain. 2009 Nov;132(Pt 11):2932-46. doi: 10.1093/brain/awp232. Epub 2009 Sep 17. Brain. 2009. PMID: 19762452 Free PMC article.
-
The Use of Biomarkers and Genetic Screening to Diagnose Frontotemporal Dementia: Evidence and Clinical Implications.Front Neurosci. 2019 Aug 6;13:757. doi: 10.3389/fnins.2019.00757. eCollection 2019. Front Neurosci. 2019. PMID: 31447625 Free PMC article.
-
Frontotemporal dementia.Lancet. 2015 Oct 24;386(10004):1672-82. doi: 10.1016/S0140-6736(15)00461-4. Lancet. 2015. PMID: 26595641 Free PMC article. Review.
-
A transdiagnostic review of neuroimaging studies of apathy and disinhibition in dementia.Brain. 2022 Jun 30;145(6):1886-1905. doi: 10.1093/brain/awac133. Brain. 2022. PMID: 35388419 Free PMC article. Review.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical