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Cited by 50Dementia and Cognitive Impairment ResearchAlzheimer's disease research and treatmentsAmyotrophic Lateral Sclerosis Research

Neuropsychiatric Symptom Profile Differs Based on Pathology in Patients with Clinically Diagnosed Behavioral Variant Frontotemporal Dementia

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Léger, Gabriel C., Banks, Sarah J.·2014·Dementia and Geriatric Cognitive Disorders
DOI 10.1159/000354368PMC PMC4041327
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Abstract

Background: Behavioral variant frontotemporal dementia (bvFTD) is pathologically heterogeneous. With emerging therapeutics, determining underlying pathology during life is increasingly important. Neuropsychiatric symptoms are prevalent and diagnostic in bvFTD. Methods: We assessed the neuropsychiatric profile of patients with clinically diagnosed bvFTD as a function of pathology at autopsy. Patients with a clinical diagnosis of bvFTD at the initial visit were selected from the National Alzheimer's Coordinating Center (NACC) database. Neuropsychiatric symptoms endorsed on the Neuropsychiatric Inventory Questionnaire (NPI-Q) were analyzed. Results: Of 149 patients with clinically diagnosed bvFTD, pathology was primarily Alzheimer's disease (AD) in 20.5%. These patients differed from those with underlying frontotemporal lobar degeneration: patients with AD pathology (plaques and tangles) were more likely to have hallucinations, delusions, or agitation. Patients were further differentiated into tau-positive (30% of cases, including Pick's disease, FTD and parkinsonism with tau-positive or argyrophilic inclusions, and other tauopathies) or tau-negative cases (70% of cases, including bvFTD tau-negative ubiquitin-positive inclusions). These patients also differed in some of the neuropsychiatric symptoms seen. Tau-negative cases were more likely to demonstrate depression, delusions, and changes in appetite and eating. Conclusions: These preliminary findings contribute to our increasing ability to predict, using simple clinical tools, the neuropathological underpinnings of bvFTD during life.

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  • bvFTD patients may exhibit compulsive perseverative thoughts or behaviors, including collecting, hoarding, and hyperphagia, while these compulsive changes are typically absent in fvAD.

    “Relatedly, bvFTD patients may exhibit compulsive perseverative thoughts or behaviors, including collecting, hoarding, and hyperphagia, while these compulsive changes are typically absent in fvAD [27].”

    From Diagnosing the frontal variant of Alzheimer’s disease: a clinician’s yellow brick road (2017) · cites this paper as [27]

    The Introduction (page not available) reports that stereotypic behaviors and changes in eating are more characteristic of clinically diagnosed bvFTD than AD. The Discussion (page not available) likewise reports more appetite and eating changes in bvFTD, but only suggests that some patients with AD pathology might have frontal-variant AD. The paper does not establish that compulsive changes are typically absent in fvAD or specifically document collecting and hoarding. (LLM, conf=0.85)

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Authors
Léger, G. C., & Banks, S. J.
Affiliations
Cleveland Clinic (US)
ORCID
Venue
Dementia and Geriatric Cognitive Disorders
Publisher
S. Karger AG
Published
2013-10-10
Volume
37
Issue
1-2
Pages
104-112
ISSN
  • 1420-8008 (ISSN-L)
  • 1421-9824
DOI
10.1159/000354368
PMC
PMC4041327
OpenAlex
W2090936875
Cited by
50
References
2
Citations by year
2025: 3 · 2024: 2 · 2023: 3 · 2022: 6 · 2021: 1 · 2020: 7 · 2019: 4 · 2018: 4 · 2017: 6 · 2016: 6 · 2015: 3 · 2014: 4
FWCI
3.08
Type
journal article
Language
en
Open access
Licence
Locations
  • Dementia and Geriatric Cognitive Disorders (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute on Aging (U01AG016976)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
  • Health Sciences › Medicine › Neurology › Amyotrophic Lateral Sclerosis Research
Keywords
behavioral variant frontotemporal dementia, neuropsychiatric symptoms, neuropathology, tauopathy, frontotemporal lobar degeneration, Alzheimer's disease pathology, hallucinations, delusions, agitation, depression, ubiquitin-positive inclusions, Pick's disease, Neuropsychiatric Inventory Questionnaire
MeSH terms
Aged, Aged, 80 and over, Alzheimer Disease, Appetite, Mental Disorders, Feeding Behavior, Female, Humans, Longitudinal Studies, Male, Middle Aged, Neuropsychological Tests, Surveys and Questionnaires, Socioeconomic Factors, Biomarkers, Databases, Factual, Neurofibrillary Tangles, tau Proteins, Frontotemporal Dementia, Plaque, Amyloid

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