Cited by 5,221Dementia and Cognitive Impairment ResearchAlzheimer's disease research and treatmentsAmyotrophic Lateral Sclerosis Research

The DOI matches its Crossref record; 179 of the 179 references it cites were found in a registry or an index.

Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia

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Abstract

Based on the recent literature and collective experience, an international consortium developed revised guidelines for the diagnosis of behavioural variant frontotemporal dementia. The validation process retrospectively reviewed clinical records and compared the sensitivity of proposed and earlier criteria in a multi-site sample of patients with pathologically verified frontotemporal lobar degeneration. According to the revised criteria, 'possible' behavioural variant frontotemporal dementia requires three of six clinically discriminating features (disinhibition, apathy/inertia, loss of sympathy/empathy, perseverative/compulsive behaviours, hyperorality and dysexecutive neuropsychological profile). 'Probable' behavioural variant frontotemporal dementia adds functional disability and characteristic neuroimaging, while behavioural variant frontotemporal dementia 'with definite frontotemporal lobar degeneration' requires histopathological confirmation or a pathogenic mutation. Sixteen brain banks contributed cases meeting histopathological criteria for frontotemporal lobar degeneration and a clinical diagnosis of behavioural variant frontotemporal dementia, Alzheimer's disease, dementia with Lewy bodies or vascular dementia at presentation. Cases with predominant primary progressive aphasia or extra-pyramidal syndromes were excluded. In these autopsy-confirmed cases, an experienced neurologist or psychiatrist ascertained clinical features necessary for making a diagnosis according to previous and proposed criteria at presentation. Of 137 cases where features were available for both proposed and previously established criteria, 118 (86%) met 'possible' criteria, and 104 (76%) met criteria for 'probable' behavioural variant frontotemporal dementia. In contrast, 72 cases (53%) met previously established criteria for the syndrome (P < 0.001 for comparison with 'possible' and 'probable' criteria). Patients who failed to meet revised criteria were significantly older and most had atypical presentations with marked memory impairment. In conclusion, the revised criteria for behavioural variant frontotemporal dementia improve diagnostic accuracy compared with previously established criteria in a sample with known frontotemporal lobar degeneration. Greater sensitivity of the proposed criteria may reflect the optimized diagnostic features, less restrictive exclusion features and a flexible structure that accommodates different initial clinical presentations. Future studies will be needed to establish the reliability and specificity of these revised diagnostic guidelines.

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  1. Rascovsky, 2007, Inter-rater reliability of diagnostic criteria for Frontotemporal Dementia (FTD): Findings from the California Non-AD Diagnostic Reliability Consortium, Neurology, 68, A354

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Metadata

Authors
Rascovsky, K., Hodges, J. R., Knopman, D., Mendez, M. F., Kramer, J. H., Neuhaus, J., van Swieten, J. C., Seelaar, H., Dopper, E. G. P., Onyike, C. U., Hillis, A. E., Josephs, K. A., Boeve, B. F., Kertesz, A., Seeley, W. W., Rankin, K. P., Johnson, J. K., Gorno-Tempini, M.-L., Rosen, H., Prioleau-Latham, C. E., Lee, A., Kipps, C. M., Lillo, P., Piguet, O., Rohrer, J. D., Rossor, M. N., Warren, J. D., Fox, N. C., Galasko, D., Salmon, D. P., Black, S. E., Mesulam, M., Weintraub, S., Dickerson, B. C., Diehl-Schmid, J., Pasquier, F., Deramecourt, V., Lebert, F., Pijnenburg, Y., Chow, T. W., Manes, F., Grafman, J., Cappa, S. F., Freedman, M., Grossman, M., & Miller, B. L.
Affiliations
  • University of Pennsylvania (US)
  • UNSW Sydney (AU)
  • Mayo Clinic (US)
  • University of California, Los Angeles (US)
  • University of California, San Francisco (US)
  • Erasmus MC (NL)
  • Johns Hopkins University (US)
  • Western University (CA)
  • University Hospital Southampton NHS Foundation Trust (GB)
  • UCL Queen Square Institute of Neurology (GB)
  • University of California San Diego (US)
  • Sunnybrook Health Science Centre (CA)
  • Northwestern University (US)
  • Université de Lille (FR)
  • Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
  • University of Toronto (CA)
  • Favaloro University (AR)
  • Kessler Foundation (US)
  • Vita-Salute San Raffaele University (IT)
Venue
Brain
Published
2011-08-02
Volume
134
Issue
9
Pages
2456-2477
ISSN
  • 0006-8950 (ISSN-L)
  • 1460-2156
OpenAlex
W2128030851
Cited by
5,221
References
179
Citations by year
2026: 333 · 2025: 445 · 2024: 486 · 2023: 427 · 2022: 456 · 2021: 460 · 2020: 459 · 2019: 355 · 2018: 338 · 2017: 325 · 2016: 293 · 2015: 276 · 2014: 225 · 2013: 208 · 2012: 115
FWCI
122.40
Type
journal article
Language
en
Open access
Locations
  • Brain (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
  • Iris (University of Trento) (submittedVersion, other-oa)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
  • Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
  • ePrints Soton (University of Southampton) (submittedVersion)
  • UCL Discovery (University College London) (submittedVersion)
  • mediaTUM (Technical University of Munich) (submittedVersion)
  • Pure Amsterdam UMC (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Funders
  • U.S. Department of Veterans Affairs
  • Alzheimer's Association
  • Bristol-Myers Squibb (AG17586)
  • Eli Lilly and Company (AG17586)
  • Pfizer (AG17586)
  • GlaxoSmithKline
  • Sanofi
  • Heart and Stroke Foundation of Canada
  • Baxter International
  • Wellcome Trust (091673)
  • Canadian Stroke Network
  • Myriad Genetics
  • Alzheimer Society
  • National Institute for Health and Care Research (NF-SI-0508-10123)
  • University of Cambridge
  • University of Oxford
  • Elan
  • Fonds Wetenschappelijk Onderzoek (P6/29)
  • Eisai
  • KU Leuven
  • Vlaamse regering
  • H. Lundbeck A/S
  • National Institutes of Health (DC008552, AG016574, AG023501, AG019724, NS53488, AG06786, AG 17586, AG13854, AG15116, AG16574, AG32953)
  • Canadian Institutes of Health Research (13129)
  • Natural Sciences and Engineering Research Council of Canada
  • National Institute on Aging (AG13854, P50‐AG16574, R01-AG15116, U01AG06786, RO1 AG15866, AG 16574, P01 AG-17586, U01AG006786, R01AG015116, P01AG017586, AG17586, R01AG034499, R01AG032306, AG019724, P01-AG32953, P01AG032953, P01AG019724, P50AG023501, P50AG016574)
  • National Institute on Deafness and Other Communication Disorders (AG13854, DC008552, R01DC005375)
  • National Institute of Neurological Disorders and Stroke (R01-NS44266, R01NS047691, R01NS044266)
  • National Center for Research Resources (UL1RR025741)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
  • Health Sciences › Medicine › Clinical Neurology › Amyotrophic Lateral Sclerosis Research
Keywords
behavioral variant frontotemporal dementia, diagnostic criteria, sensitivity, frontotemporal lobar degeneration, disinhibition, apathy, hyperorality, dysexecutive syndrome, functional disability, neuroimaging, diagnostic accuracy
MeSH terms
Aged, Behavior, Female, Humans, Male, Middle Aged, Neuropsychological Tests, Sensitivity and Specificity, Reproducibility of Results, Guidelines as Topic, Frontotemporal Dementia

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