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[P2–296]: BEHAVIOURAL AND PHYSIOLOGICAL RESPONSES TO LAUGHTER IN FRONTOTEMPORAL DEMENTIA
Author(s) -
Sivasathiaseelan Harri,
Benhamou Elia,
Marshall Charles R.,
Russell Lucy L.,
Hardy Chris J.D.,
Bond Rebecca L.,
Scott Sophie K.,
Rohrer Jonathan D.,
Warren Jason D.
Publication year - 2017
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.2017.06.949
Subject(s) - laughter , psychology , frontotemporal dementia , cognition , social cognition , cognitive psychology , dementia , neuroscience , developmental psychology , disease , medicine , pathology
Recent studies have yielded consensus neuropathological diagnostic criteria for the distinctive pattern of hyperphosphorylated tau deposition in patients with prior TBI exposure that has been termed chronic traumatic encephalopathy (CTE). However, clinical diagnosis of this condition remains challenging and four separate provisional criteria have been developed for CTE or its analogous clinical construct, traumatic encephalopathy syndrome (TES; Jordan, 2013; Victoroff, 2013; Montenigro et al., 2014; Reams et al., 2016). The utility of these competing diagnostic criteria remains uncertain. Methods:We performed retrospective chart reviews on 180 patients scheduled in the West Los Angeles VA Neurobehavior Clinic from January through June of 2016 for work-up of cognitive and/or behavioral complaints. We identified 40 patients with prior TBI exposure, who subsequently underwent comprehensive chart review by 2 independent raters to determine whether they fulfilled each of the 4 provisional diagnostic criteria for CTE/TES. These data were used to determine: 1) the relative frequency of CTE/ TES in this clinic population using each criteria, 2) the inter-rater reliability for each criteria, and 3) the concordance of CTE/TES diagnoses between different criteria. Results:Averaged across raters, the prevalence of possible or probable CTE/TES amongst patients with prior TBI was lowest using Jordan criteria (19%), intermediate using Montenigro and Reams criteria (30%), and highest using Victoroff criteria (35%). Inter-rater reliability was relatively higher with Jordan (k1⁄40.75) and Montenigro (k1⁄40.64) criteria than with Victoroff (k1⁄40.46) or Reams (k1⁄40.41) criteria. Across raters, the concordance between possible or probable CTE/TES diagnoses was highest between Montenigro and Reams criteria (k1⁄40.40) and lowest between Jordan and Victoroff criteria (k1⁄4-0.32). Conclusions: A significant proportion of patients within this high-risk population met criteria for possible or probable CTE/TES. While the inter-rater reliabilities of these criteria were in the moderate to substantial range, the concordances between diagnostic criteria were only fair to poor. Given the limited overlap of CTE/TES diagnoses using these different criteria, more definitive clinical identification of this syndrome may depend on further development of tau-specific neuroimaging technologies.