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Arch Neurol. 2006 Nov;63(11):1627-31.

Progression in frontotemporal dementia: identifying a benign behavioral variant by magnetic resonance imaging.

Author information

1
Department of Clinical Neurosciences, University of Cambridge, Addenbrooke's Hospital, Cambridge, England.

Abstract

OBJECTIVE:

To assess the clinical course and prognosis in patients with behavioral-variant frontotemporal dementia (FTD) lacking evidence of brain atrophy on magnetic resonance imaging (MRI).

DESIGN:

Patients were enrolled into this prospective cohort study over a period of 15 years; cognitive status, duration of symptoms, and behavioral indexes were recorded. Brain MRIs were rated using a standardized scale.

SETTING:

Regional early-onset dementia clinic.

PARTICIPANTS:

Thirty-one participants diagnosed clinically with behavioral-variant FTD. Intervention Rating of MRIs.

MAIN OUTCOME MEASURES:

Death or institutionalization after a minimum of 3 years' follow-up indicated poor prognosis, while the ability to live independently was regarded as a good prognosis for the purpose of survival (Kaplan-Meier) and discriminant function analysis.

RESULTS:

Patients with normal or borderline MRI findings (n = 15) showed significantly longer survival to institutionalization or death than those (n = 16) with definite frontotemporal atrophy (mean +/- SE, 9.3 +/- 1.7 years vs 3.0 +/- 0.7 years; P<.01). Using groups defined by 3-year outcome (good or bad prognosis), cerebral atrophy predicted poor outcome while age, symptom duration, cognitive performance, behavioral impairment, and overall disability at baseline did not.

CONCLUSIONS:

Patients with FTD with normal MRI results follow a more benign course than cases with atrophy at presentation. The substrate of the behavioral symptoms in such cases may differ from the neurodegenerative pathological features typically associated with FTD.

PMID:
17101833
DOI:
10.1001/archneur.63.11.1627
[Indexed for MEDLINE]

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