Identifying specific clinical symptoms of behavioral variant frontotemporal dementia versus differential psychiatric disorders in patients presenting with a late-onset frontal lobe syndrome
Abstract
Objective Early differentiation between psychiatric disorders and behavioral variant frontotemporal dementia (bvFTD) is of paramount importance in patients with the late-onset frontal lobe syndrome. As bvFTD in patients will deteriorate, psychiatric disorders are treatable. To date, misdiagnosis often occurs due to an overlap of symptoms and lack of specific biomarkers. The aim of our study was to investigate whether specific symptoms could separate bvFTD from psychiatric disorders. Methods In a naturalistic, prospective, multicenter study, 137 patients (aged 45-75 years, 72% male) with a late-onset frontal lobe syndrome were included based on their scores on the Frontal Behavioral Inventory (FBI) and the Stereotypy Rating Inventory (SRI) from April 2011 to June 2013. In a multidisciplinary consensus meeting, diagnoses were established based on elaborate neuropsychological testing, magnetic resonance imaging, fludeoxyglucose F 18 positron emission tomography, cerebrospinal fluid biomarkers, and clinical examination by a neurologist and a psychiatrist based on the International bvFTD Criteria Consortium for bvFTD and DSM-IV-TR criteria for psychiatric disorders. Results Forty-four subjects (32.8%) were diagnosed with a psychiatric disorder, 10 (7.3%) with possible bvFTD, and 45 (32.8%) with probable bvFTD. A logistic regression analysis was performed with "psychiatry or bvFTD" as dependent variable and clinical variables (Montgomery-Asberg Depression Rating Scale [MADRS], SRI,…
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The Frontal Behavioral Inventory (FBI) overall score does not distinguish bvFTD from PPD.
“the overall score does not distinguish bvFTD from PPD (Kertesz et al. , 2000; Alberici et al. , 2007; Milan et al. , 2008; Krudop et al. , 2015; Dols et al. , 2016; Suhonen et al. , 2017).”
From Recommendations to distinguish behavioural variant frontotemporal dementia from psychiatric disorders (2020) · cites this paper as Dols et al., 2016
Specific FBI sub-items that support bvFTD more than an idiopathic psychiatric state are aphasia and verbal apraxia, indifference/emotional flatness, alien hand and apraxia, and inappropriateness, whereas irritability is more indicative of PPD.
“The specific sub-items of the FBI that have been found to support bvFTD more than an idiopathic psychiatric state are 'aphasia and verbal apraxia, indifference/emotional flatness, alien hand and apraxia, and inappropriateness' whereas 'irritability' is more indicative of a PPD (Kertesz et al. , 2000; Dols et al. , 2016).”
From Recommendations to distinguish behavioural variant frontotemporal dementia from psychiatric disorders (2020) · cites this paper as Dols et al., 2016
Stereotypies are more commonly present in bvFTD than in patients with similar presenting symptoms but a final diagnosis of PPD.
“stereotypies were shown to be more commonly present in bvFTD than in patients with similar presenting symptoms but with a final diagnosis of PPD (Krudop et al. , 2015; Dols et al. , 2016).”
From Recommendations to distinguish behavioural variant frontotemporal dementia from psychiatric disorders (2020) · cites this paper as Dols et al., 2016
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Ducharme, S., Dols, A., Laforce, R., Devenney, E., Kumfor, F., van den Stock, J., Dallaire-Théroux, C., Seelaar, H., Gossink, F., Vijverberg, E., et al. (2020) · Brain · doi:10.1093/brain/awaa018 · Cited by 320 · see citing works
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Self-citationDucharme, S., Pearl-Dowler, L., Gossink, F., McCarthy, J., Lai, J., Dickerson, B. C., Chertkow, H., Rapin, L., Vijverberg, E., Krudop, W., et al. (2019) · Journal of Alzheimer's Disease · doi:10.3233/jad-180839 · Cited by 42 · see citing works
Self-citationPsychosis in behavioral variant frontotemporal dementia
Gossink, F. T., Vijverberg, E. G., Krudop, W., Scheltens, P., Stek, M. L., Pijnenburg, Y. A., & Dols, A. (2017) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s127863 · Cited by 36 · see citing works
Self-citationCheran, G., Silverman, H., Manoochehri, M., Goldman, J., Lee, S., Wu, L., Cines, S., Fallon, E., Kelly, B. D., Olszewska, D. A., et al. (2018) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp-2017-317263 · Cited by 32 · see citing works
Pressman, P. S., Matlock, D., & Ducharme, S. (2021) · The Journal of Neuropsychiatry and Clinical Neurosciences · doi:10.1176/appi.neuropsych.20090238 · Cited by 30 · see citing works
Reus, L. M., Vijverberg, E. G., Tijms, B. M., Kate, M. T., Gossink, F., Krudop, W. A., Campo, M. D., Teunissen, C. E., Barkhof, F., van der Flier, W. M., et al. (2018) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2018.07.014 · Cited by 26 · see citing works
Self-citationZhutovsky, P., Vijverberg, E. G. B., Bruin, W. B., Thomas, R. M., Wattjes, M. P., Pijnenburg, Y. A. L., van Wingen, G. A., & Dols, A. (2019) · Journal of Alzheimer's Disease · doi:10.3233/jad-181004 · Cited by 20 · see citing works
Self-citationPredicting progression in the late onset frontal lobe syndrome
Gossink, F. T., Vijverberg, E., Krudop, W., Scheltens, P., Stek, M. L., Pijnenburg, Y. A. L., & Dols, A. (2019) · International Psychogeriatrics · doi:10.1017/s1041610218001242 · Cited by 10 · see citing works
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- Authors
- Dols, A., van Liempt, S., Gossink, F., Krudop, W. A., Sikkes, S., Pijnenburg, Y. A. L., & Stek, M. L.
- Affiliations
- GGZ inGeest (NL)
- Amsterdam Neuroscience (NL)
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2016-07-05
- Volume
- 77
- Issue
- 10
- Pages
- 1391-1395
- ISSN
- 0160-6689 (ISSN-L)
- OpenAlex
- W2469101055
- Cited by
- 25
- References
- 0
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 1 · 2022: 3 · 2021: 2 · 2020: 3 · 2019: 4 · 2018: 6 · 2017: 3
- FWCI
- 3.85
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- 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 › Amyotrophic Lateral Sclerosis Research
- Keywords
- behavioral variant frontotemporal dementia, differential diagnosis, mental illness, Frontal Behavioral Inventory, irritability, impulsivity, apraxia of speech, depression, diagnostic biomarkers, misdiagnosis
- MeSH terms
- Age Factors, Aged, Mental Disorders, Compulsive Behavior, Diagnosis, Differential, Female, Hospitals, Psychiatric, Humans, Inhibition, Psychological, Male, Middle Aged, Netherlands, Stereotyped Behavior, Comorbidity, Frontotemporal Dementia, Apathy
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