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P2–218: Prion disease manifested as frontotemporal dementia in octogenarians
Author(s) -
Wu ChuangKuo
Publication year - 2013
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.2013.05.864
Subject(s) - akinetic mutism , medicine , pediatrics , dementia , disease , myoclonus , frontotemporal dementia , memory impairment , psychiatry , cognition
is known about its clinical features. Few studies have described association between AGD and neuropsychiatric symptoms (NPS)s and/or personality changes. The susceptible AGD areas are the entorhinal and transentorhinal cortices, the first sector of Ammon’s horn and the basolateral amygdala and the hypothalamic lateral tuberal nucleus . We aimed to investigate the association of NPSs and AGD. Methods:Data from a nonconvenience post-mortem cohort evaluating individuals aged 60 years or more were used. Neuropsychiatric symptoms (delusions, hallucinations, agitation, dysphoria, anxiety, apathy, irritability, euphoria, disinhibition, aberrant motor behavior, nighttime disturbances and appetite and eating abnormalities) were evaluated by applying the Neuropsychiatric Inventory (NPI) to a knowledgeable informant. Multivariate logistic regression models were used to assess the association between AGD and NPS, adjusted for possible confounders (age, sex, schooling, dementia severity, and other neuropathologic lesions). Results: Clinical and neuropathologic evaluations were available for 310 individuals. Among them, 98 had AGD and 51.1% had variable degrees of NPS. AGD was associated with NPSs (OR1⁄41.96, 95% CI 1.03-3.72, p1⁄40.04) in the multivariate logistic model. Among NPSs, only appetite disorders were related to AGD (OR1⁄42.71, 95% CI 1.34-5.48, p1⁄40.006). Conclusions: AGD seems to be associated particularly to appetite changes. The neuroanatomical basis for the changes in appetite remained unclear, but the ventromedial and lateral hypothalamic are believed to play a critical role. Interestingly, the lateral tuberal nuclei is vulnerable to AGD changes and our results may point to a possible clinical symptom that can be used to identify AGD prior to autopsy.