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P4–110: Parietal lobe dysfunction in Frontotemporal Dementia
Author(s) -
Schmidtke Klaus,
Huell Michael
Publication year - 2006
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2006.05.1849
Subject(s) - copying , frontotemporal dementia , psychology , neuropsychology , semantic dementia , audiology , dementia , cognition , frontal lobe , cognitive psychology , neuroscience , medicine , disease , political science , law
Objectives: Frontotemporal Dementia (FTD) is regarded as the prototypical anterior dementia, but cortical degenerative changes can extend to posterior areas, as shown by stuctural imaging [1] and SPECT. FTD patients do show neuropsychological deficits of visuo-spatial cognition. We assume that these are, in part, caused by parietal lobe dysfunction, rather than by impairment of executive control, attitude and goal orientation alone. To investigate this issue, we analyzed performances in several tests of visuo-spatial cognition in FTD patients and compared them to Alzheimer (AD) patients. Methods: CERAD figure copying, Rey figure copying, clock reading and clock drawing were analysed in 50 FTD patients (MMSE 14) and in a group of 72 AD patients (MMSE 20). Rey figure copying and clock drawing require “planning,” while clock reading and copying of simple figures are rather pure tests of visuo-spatial cognition. The two groups were matched for an identical mean MMSE of 23.3. FTD patients with early aphasia not included. Results: FTD patients were almost equally impaired at CERAD figure copying (FTD mean 9.1, AD 8.7, max. score 11) and clock drawing (FTD mean Shulman score 3.0, AD 3.3). FTD patients were slightly less impaired at clock reading (mean 8.8 vs. 8.0, max. score 12). They scored significantly better at Rey figure copying (mean 30.3 vs. 24.4, max. score 36, p 0.022). In the subgroup of the 20 FTD patients with MMSE 25, six each had pathological scores at clock reading, clock drawing and CERAD figure copying. Conclusions: FTD patients’ impairments in tests of visuo-spatial function were close to those of a matched AD group, except for better Rey figure copying. Deficits at clock drawing and Rey figure copying may be explained by “executive dysfunction,” but deficits at CERAD figure copying and clock reading are suggestive of genuine visuo-spatial dysfunction. In contrast to common belief, but in accordance with imaging finding, parietal lobe pathology and dysfunction may be a regular feature of FTD. 1. Whitwell JL et al. Longitudinal patterns of regional change on volumetric MRI in frontotemporal lobar degeneration. Dement Geriatr Cogn Disord. 2004, 17: 307-310.