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Episodic memory in frontotemporal dementia: a critical review
Open accessAbstract
This review offers a critical appraisal of the literature on episodic memory performance in frontotemporal dementia. Historically, description of patients diagnosed with what was then known as Pick's disease included the presence of memory deficits and an underlying amnestic syndrome was noted in some of these patients. Over the last 20 years, however, the clinical view has been that episodic memory processing is relatively intact in the frontotemporal dementia syndrome. In particular, patients with the subtypes of behavioural variant frontotemporal dementia and progressive non-fluent aphasia are reported to perform within normal limits on standard memory tests. In the third clinical presentation of frontotemporal dementia, semantic dementia, relatively intact episodic memory against a significantly impaired semantic memory was regarded as the hallmark. This position was instrumental in the development of clinical diagnostic criteria for frontotemporal dementia in which amnesia was explicitly listed as an exclusion criterion for the disease. The relative intactness of episodic memory, therefore, appeared to be a useful diagnostic marker to distinguish early frontotemporal dementia from Alzheimer's disease, in which early episodic memory disturbance remains the most common clinical feature. We argue that recent evidence questions the validity of preserved episodic memory in frontotemporal dementia, particularly in behavioural variant frontotemporal dementia. In semantic dementia, a complex picture emerges with preservation of some components of episodic memory, notably recognition-based visual memory and recall of recent autobiographical events. We propose a critical synthesis of recent neuropsychological evidence on retrograde and anterograde memory in light of neuroimaging and neuropathological findings, demonstrating involvement of medial temporal structures in frontotemporal dementia, structures known to be critical for episodic memory processing. We further argue that the multifactorial nature of most memory tests commonly used clinically fail to capture the memory deficits in frontotemporal dementia and that sensitive assessment tools of memory are needed. Together, recent clinical and experimental findings and the historical evidence represent a strong case for a re-evaluation of the importance of memory disturbance in the clinical diagnosis of frontotemporal dementia.
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“Furthermore, 10% of pathologically-confirmed bvFTD subjects show marked episodic memory deficits at initial presentation, contrary to current diagnostic criteria (Hodges et al. , 2004; Hornberger and Piguet, 2012; Bertoux et al. , 2018).”
From Recommendations to distinguish behavioural variant frontotemporal dementia from psychiatric disorders (2020) · cites this paper as Hornberger and Piguet, 2012
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Metadata
- Authors
- Hornberger, M., & Piguet, O.
- Affiliations
- UNSW Sydney (AU)
- Venue
- Brain
- Publisher
- Oxford University Press (OUP)
- Published
- 2012-02-24
- Volume
- 135
- Issue
- 3
- Pages
- 678-692
- ISSN
- 0006-8950 (ISSN-L)
- 1460-2156
- OpenAlex
- W2135433550
- Cited by
- 210
- References
- 142
- Citations by year
- 2026: 7 · 2025: 8 · 2024: 16 · 2023: 11 · 2022: 12 · 2021: 17 · 2020: 13 · 2019: 17 · 2018: 15 · 2017: 13 · 2016: 18 · 2015: 22 · 2014: 16 · 2013: 22 · 2012: 3
- FWCI
- 2.72
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Brain (publishedVersion)
- PubMed (publishedVersion)
- UNSWorks (UNSW Sydney) (submittedVersion, cc-by-nc-nd)
- UEA Digital Repository (University of East Anglia) (submittedVersion)
- UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by-nc-nd)
- Funders
- Australian Research Council
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory Processes and Influences
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
- Keywords
- frontotemporal dementia, episodic memory, behavioral variant frontotemporal dementia, semantic dementia, progressive nonfluent aphasia, Pick's disease, amnestic syndrome, retrograde amnesia, anterograde amnesia, medial temporal lobe, memory assessment, differential diagnosis from Alzheimer's disease, autobiographical memory, recognition memory
- MeSH terms
- Amnesia, Retrograde, Behavior, Brain, Humans, Neurology, Neuropsychological Tests, Psychomotor Performance, Amnesia, Anterograde, Pick Disease of the Brain, History, 19th Century, History, 20th Century, Primary Progressive Nonfluent Aphasia, Frontotemporal Dementia, Memory, Episodic
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