Neural correlates of fat preference in frontotemporal dementia: translating insights from the obesity literature
Open accessAbstract
Objective: Alterations in eating behaviour are one of the diagnostic features of behavioural variant frontotemporal dementia (bvFTD). It is hypothesised that underlying brain network disturbances and atrophy to key structures may affect macronutrient preference in bvFTD. We aimed to establish whether a preference for dietary fat exists in bvFTD, its association with cognitive symptoms and the underlying neural mechanisms driving these changes. Methods: Using a test meal paradigm, adapted from the obesity literature, with variable fat content (low 20%, medium 40% and high 60%), preference for fat in 20 bvFTD was compared to 16 Alzheimer’s disease (AD) and 13 control participants. MRI brain scans were analysed to determine the neural correlates of fat preference. Results: Behavioural variant FTD patients preferred the high‐fat meal compared to both AD (U = 61.5; p = 0.001) and controls (U = 41.5; p = 0.001), with 85% of bvFTD participants consistently rating the high‐fat content meal as their preferred option. This increased preference for the high‐fat meal was associated with total behavioural change (Cambridge Behavioural Inventory: r s = 0.462; p = 0.001), as well as overall functional decline (Frontotemporal Dementia Rating Scale: r s = −0.420; p = 0.03). A preference for high‐fat content in bvFTD was associated with atrophy in an extended brain network including frontopolar, anterior cingulate, insular cortices, putamen and amygdala extending into lateral temporal, posteromedial parietal and occipital cortices. Conclusions: Increased preference for fat content is associated with many of the canonical features of bvFTD. These findings offer new insights into markers of disease progression and pathogenesis, providing potential treatment targets.
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Disease progression in bvFTD has been associated with various behavioral changes, from an increase in core features to specific changes, that correlate with FTD-specific progression measures.
“Disease progression in bvFTD has been associated with various behavioral changes, from an increase in core features, e.g., decreased socio-emotional abilities and increased multi-dimensional apathy, to specific changes, e.g., increased fat preference and hypersensitivity to loud noises (Midorikawa et al., 2016; Wei et al., 2020; Ahmed et al., 2021; Foster et al., 2022), that correlate with FTD-s”
From The pursuit for markers of disease progression in behavioral variant frontotemporal dementia: a scoping review to optimize outcome measures for clinical trials (2024) · cites this paper as Ahmed et al., 2021
Specific metabolic changes were found in bvFTD compared to controls, such as altered metabolites in a wide range of pathways and increased fat preference.
“specific metabolic changes were found in bvFTD (compared to controls), such as altered metabolites in a wide range of pathways (including amino acids, energy and carbohydrate, cofactor and vitamin, lipid and nucleotide) and increased fat preference”
From The pursuit for markers of disease progression in behavioral variant frontotemporal dementia: a scoping review to optimize outcome measures for clinical trials (2024) · cites this paper as Ahmed et al., 2021
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- Authors
- Ahmed, R. M., Tse, N. Y., Chen, Y., Henning, E., Hodges, J. R., Kiernan, M. C., Irish, M., Farooqi, I. S., & Piguet, O.
- Affiliations
- The University of Sydney (AU)
- University of Cambridge (GB)
- Corresponding author
- Ahmed, Rebekah M.
- ORCID
- Venue
- Annals of Clinical and Translational Neurology
- Publisher
- Wiley
- Published
- 2021-05-11
- Volume
- 8
- Issue
- 6
- Pages
- 1318-1329
- ISSN
- 2328-9503 (ISSN-L)
- PMC
- PMC8164857
- OpenAlex
- W3161243732
- Cited by
- 12
- References
- 50
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 3 · 2022: 2 · 2021: 1
- FWCI
- 1.08
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Annals of Clinical and Translational Neurology (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Apollo (University of Cambridge) (submittedVersion, cc-by-nc-nd)
- Apollo
- Funders
- National Health and Medical Research Council ((#1037746, #1003139, #1120770, #1156093, #1103258)
- Centre of Excellence in Cognition and its Disorders, Australian Research Council (#CE110001021, FT160100096)
- Royal Australasian College of Physicians
- Motor Neurone Disease Research Institute of Australia
- Australian Research Council
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- behavioral variant frontotemporal dementia, fat preference, macronutrient preference, eating behaviour, neural correlates, brain atrophy, frontopolar cortex, anterior cingulate cortex, insula, amygdala, putamen, Alzheimer's disease, disease progression biomarkers, functional decline
- MeSH terms
- Aged, Alzheimer Disease, Amygdala, Atrophy, Cerebral Cortex, Dietary Fats, Female, Food Preferences, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Nerve Net, Obesity, Putamen, Frontotemporal Dementia, Patient Acuity
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