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P4–112: Is early frontotemporal dementia a dementia?
Author(s) -
Mendez Mario F.,
McMurtray Aaron,
Licht Eliot A.,
Saul Ronald E.,
Miller Bruce L.
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.2006.05.1851
Subject(s) - frontotemporal dementia , dementia , semantic dementia , primary progressive aphasia , neuropsychology , psychology , frontotemporal lobar degeneration , psychiatry , disease , neuropsychological assessment , pediatrics , medicine , cognition
Background: In the absence of a biomarker, the diagnosis of frontotemporal dementia (FTD) depends on recognizing the neuropsychiatric symptoms of this disease. The traditional model of cognitive loss of Alzheimer’s disease (AD) may not apply in the beginning stages of FTD, when patients have predominant behavioral symptoms. Patients with early FTD often lack the multiple cognitive impairments or memory loss necessary to meet established criteria (DSM-IV or ICD-10) for dementia. Objective: To determine whether patients with FTD meet criteria for dementia on presentation within two years of onset of their disease. Methods: We reviewed all patients meeting Consensus Criteria for FTD (Neary et al, 1998) and having corroborative frontal or frontotemporal changes on functional neuroimaging (either PET or SPECT). All FTD patients in this study presented for evaluation in universitybased neurological clinics. All patients were within two years of onset of their first symptoms. This study included only the behavioral variant of frontotemporal lobar degeneration and excluded patients with primary progressive aphasia or semantic dementia. All patients underwent initial neurobehavioral and neuropsychological testing at baseline and again at two years. Results: On initial presentation, 23 (36.5%) patients met all core criteria for FTD and were diagnosed with the disorder; an additional 40 patients met all core criteria at two years from the initial presentation. Of these 63 patients eventually diagnosed with FTD, none met criteria (DSM-IV or ICD-10) for dementia at baseline by neurobehavioral or neuropsychological testing, and 43 (68.3%) met dementia criteria at two years from the initial presentation. Most FTD patients initially lacked sufficient memory and other cognitive deficits to characterize as “dementia.” Conclusion: FTD is often difficult to diagnose. Patients with FTD present with subtle personality or behavioral changes rather than cognitive deficits typical of AD. Although neuropsychological studies report abnormalities in frontal-executive functions and language, with less impaired memory and visuospatial skills than AD, the non-cognitive behavioral changes are actually the earliest and most characteristic features of FTD. This report suggests that early FTD defies the neuropsychological model of dementia and that clinicians need better diagnostic tools for recognizing this neuropsychiatric disorder. P4-113 CLINICOPATHOLOGIC AND BIOCHEMICAL OVERLAP OF FRONTOTEMPORAL DEGENERATION, CORTICOBASAL DEGENERATION AND PROGRESSIVE SUPRANUCLEAR PALSY: THE LILLE-BAILLEUL FRENCH COHORT Vincent Deramecourt, Stéphanie Bombois, Claude-Alain Maurage, Florence Lebert, André Delacourte, Florence Pasquier, Memory Clinic, University Hospital, Lille, France; Department of Neuropathology, University Hospital, Lille, France; INSERM U815, Lille, France. Contact e-mail: v-deramecourt@chru-lille.fr