Predicting progression in the late onset frontal lobe syndrome
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ABSTRACTA late onset frontal lobe syndrome (LOF) refers to a clinical syndrome with apathy, disinhibition, or stereotypical behavior arising in middle or late adulthood. Diagnostics are challenging, and both clinicians and patients need reliable predictors of progression to improve clinical guidance. In this longitudinal multicenter and genetically screened prospective study, 137 LOF patients with frontal behavior (FBI score≥11) and/or stereotypical behavior (SRI≥10) were included. Progression was defined as institutionalization, death, or progression of frontal or temporal atrophy at magnetic resonance imaging (MRI) after two years of follow up. Absence of progression at MRI in addition to stable or improved Mini Mental State Examination and Frontal Assessment Battery scores after two years was indicative for non-progression. The presence of stereotypy and a neuropsychological profile with executive deficits at baseline were found to be predictive for progression, while a history and family history with psychiatric disorders were predictors for non-progression. The combination of these clinical markers had a predictive value of 80.4% (p < 0.05). In patients presenting with late onset behavioral symptoms, an appraisal of the rate of deterioration can be made by detailed mapping of clinical symptoms. Distinction of progressive discourses from non-progressive or treatable conditions is to be gained.
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While one study reported no change of stereotypy over time, the SRI predicted progression of frontotemporal atrophy, institutionalization and death.
“While one study reported no change of stereotypy over time, the SRI predicted progression of frontotemporal atrophy, institutionalization and death (Reus et al., 2018; Gossink et al., 2019) (Table 1).”
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 Gossink et al., 2019
If impaired at presentation, executive dysfunction was the most potent predictor of progression, including grey matter atrophy, institutionalization and mortality.
“If impaired at presentation, executive dysfunction was most potent predictor of progression, including grey matter atrophy, institutionalization and mortality (Hornberger et al., 2008; Gossink et al., 2019).”
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 Gossink et al., 2019
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- Authors
- Gossink, F. T., Vijverberg, E., Krudop, W., Scheltens, P., Stek, M. L., Pijnenburg, Y. A. L., & Dols, A.
- Affiliations
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- Corresponding author
- Gossink, Flora T.
- ORCID
- Venue
- International Psychogeriatrics
- Publisher
- Elsevier BV
- Published
- 2019-05
- Volume
- 31
- Issue
- 5
- Pages
- 743-748
- ISSN
- 1041-6102 (ISSN-L)
- OpenAlex
- W2898094620
- Cited by
- 10
- References
- 19
- Citations by year
- 2026: 1 · 2024: 3 · 2022: 2 · 2021: 1 · 2020: 3
- FWCI
- 0.78
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Psychogeriatrics (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Psychology › Clinical Psychology › Historical and Modern Theater Studies
- Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
- Keywords
- progression prediction, apathy, disinhibition, stereotypy, frontal lobe atrophy, temporal lobe atrophy, executive dysfunction, Frontal Assessment Battery, family history of mental illness, institutionalization
- MeSH terms
- Mental Status and Dementia Tests, Aged, Atrophy, Female, Frontal Lobe, Humans, Longitudinal Studies, Magnetic Resonance Imaging, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, Logistic Models, Disease Progression, Frontotemporal Dementia
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