Which neuropsychiatric and behavioural features distinguish frontal and temporal variants of frontotemporal dementia from Alzheimer's disease?
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OBJECTIVES: To investigate the prevalence of changes in mood, personality, and behaviour in frontotemporal dementia (FTD) and Alzheimer's disease (AD) and hence, which features reliably distinguish between them. To establish whether the frontal and temporal variants of FTD are characterised by different behavioural changes. METHODS: A questionnaire was designed to assess a wide range of neuropsychiatric changes; it incorporated features reported in previous studies of FTD and components of the neuropsychiatric inventory.(1) This was completed by 37 carers of patients with Alzheimer's disease (AD) and 33 patients with frontotemporal dementia (FTD), comprising 20 with temporal variant FTD (tv FTD) or semantic dementia and 13 with frontal variant FTD (fv FTD). An exploratory principal components factor analysis and discriminant function analysis was applied. RESULTS: Factor analysis showed four robust and meaningful symptom clusters: factor 1-stereotypic and eating behaviour; factor 2-executive dysfunction and self care; factor 3-mood changes; factor 4-loss of social awareness. Only stereotypic and altered eating behaviour and loss of social awareness reliably differentiated AD from FTD with no effect of disease severity. By contrast, executive dysfunction, poor self care, and restlessness showed a significant effect of disease severity only, with the more impaired patients scoring more highly. Changes in mood were found to be equally prevalent in the three patient groups. Analysis of individual symptoms showed increased rates of mental rigidity and depression in the patients with semantic dementia compared with those with fv FTD. Conversely, the latter group showed greater disinhibition. Discriminant function analysis correctly classified 71.4% overall and 86.5% of the patients with AD. CONCLUSIONS: This questionnaire disclosed striking differences between patients with FTD and AD, but only stereotypic behaviour, changes in eating preference, disinhibition, and features of poor social awareness reliably separated the groups. The patients with fv FTD and semantic dementia were behaviourally very similar, reflecting the involvement of a common network, the ventral frontal lobe, temporal pole, and amygdala. Dysexecutive symptoms and poor self care were found to be affected by the severity of the disease, reflecting perhaps spread to dorsolateral prefrontal areas relatively late in the course of both FTD and AD. This questionnaire may be of value in the diagnosis and the monitoring of therapies.
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Neurodegeneration of anterior temporal and ventral frontal lobes commonly causes morally inappropriate behaviour and lack of emotional concern.
“Neurodegeneration of the anterior temporal and ventral frontal lobes are common causes of morally inappropriate behaviour and lack of emotional concern (Bozeat et al., 2000;Edwards-Lee et al., 1997;Mendez et al., 2005;Neary et al., 1998).”
From Affective Cognition and its Disruption in Mood Disorders (2011) · cites this paper as Bozeat et al., 2000
Semantic dementia is characterized by profound and amodal loss of semantic memory.
“Semantic dementia is a progressive neurodegenerative condition characterized by the profound and amodal loss of semantic memory in the context of relatively preserved episodic memory.”
From Considering the role of semantic memory in episodic future thinking: evidence from semantic dementia (2012) · cites this paper as Bozeat et al., 2000
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Affective Cognition and its Disruption in Mood Disorders
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The Cambridge Behavioural Inventory revised
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Activities of daily living in frontotemporal dementia and Alzheimer disease
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Recognition of Emotion in the Frontal and Temporal Variants of Frontotemporal Dementia
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Neuroanatomy of Apathy and Disinhibition in Frontotemporal Lobar Degeneration
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Factors underlying caregiver stress in frontotemporal dementia and Alzheimer's disease
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Parkinsonism, movement disorders and genetics in frontotemporal dementia
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Quantifying the Eating Abnormalities in Frontotemporal Dementia
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Emotion recognition in frontotemporal dementia and Alzheimer's disease: A new film-based assessment
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Clinicopathologic differences among patients with behavioral variant frontotemporal dementia
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Characteristics of frontotemporal dementia patients with a <i>Progranulin</i> mutation
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Sleep Disturbances in Frontotemporal Dementia
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ALS and frontotemporal dysfunction: a review
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Longitudinal change in everyday function and behavioral symptoms in frontotemporal dementia
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Behavioral disturbances in the course of frontotemporal dementia
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Pharmacotherapy for Neuropsychiatric Symptoms in Frontotemporal Dementia
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Prospective evaluation of behavioral scales in the behavioral variant of frontotemporal dementia
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Neurodegenerative Disorders of Speech and Language: Non-language-dominant Diseases
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- Authors
- Bozeat, S.
- Affiliations
- MRC Cognition and Brain Sciences Unit (GB)
- Corresponding author
- Bozeat, S.
- Venue
- Journal of Neurology, Neurosurgery & Psychiatry
- Publisher
- BMJ
- Published
- 2000-08-01
- Volume
- 69
- Issue
- 2
- Pages
- 178-186
- ISSN
- 0022-3050 (ISSN-L)
- PMC
- PMC1737062
- OpenAlex
- W2117095913
- Cited by
- 603
- References
- 78
- Citations by year
- 2026: 7 · 2025: 9 · 2024: 14 · 2023: 11 · 2022: 8 · 2021: 22 · 2020: 24 · 2019: 21 · 2018: 21 · 2017: 22 · 2016: 29 · 2015: 38 · 2014: 27 · 2013: 27 · 2012: 33
- FWCI
- 10.70
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Neurology Neurosurgery & Psychiatry (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion, other-oa)
- Funders
- National Institutes of Health
- Medical Research Council
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Social Sciences › Psychology › Clinical Psychology › Historical and Modern Theater Studies
- Keywords
- frontotemporal dementia, Alzheimer's disease, semantic dementia, neuropsychiatric symptoms, behavioural symptoms, stereotypy, eating behaviour, disinhibition, mood changes, executive dysfunction, self-care, social awareness, disease severity, differential diagnosis, amygdala, temporal pole
- MeSH terms
- Aged, Aged, 80 and over, Alzheimer Disease, Analysis of Variance, Behavioral Symptoms, Dementia, Diagnosis, Differential, Diagnostic Techniques, Neurological, Female, Humans, Longitudinal Studies, Male, Middle Aged, Neuropsychological Tests, Surveys and Questionnaires, Discriminant Analysis
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