Format

Send to

Choose Destination
Neurology. 2015 Oct 13;85(15):1310-7. doi: 10.1212/WNL.0000000000002018. Epub 2015 Sep 16.

Eating behavior in frontotemporal dementia: Peripheral hormones vs hypothalamic pathology.

Author information

1
From Neuroscience Research Australia (R.M.A., S.L., L.B., M.I., G.M.H., M.C.K., J.R.H., O.P.), Sydney; Prince of Wales Clinical School (R.M.A.), School of Medical Sciences (G.M.H., J.R.H., O.P.), School of Psychology (M.I.), and ARC Centre of Excellence in Cognition and Its Disorders (R.M.A., M.I., J.R.H., O.P.), the University of New South Wales, Sydney; and Sydney Medical School (M.C.K.), Brain and Mind Centre, University of Sydney, Australia. r.ahmed@neura.edu.au o.piguet@neura.edu.au.
2
From Neuroscience Research Australia (R.M.A., S.L., L.B., M.I., G.M.H., M.C.K., J.R.H., O.P.), Sydney; Prince of Wales Clinical School (R.M.A.), School of Medical Sciences (G.M.H., J.R.H., O.P.), School of Psychology (M.I.), and ARC Centre of Excellence in Cognition and Its Disorders (R.M.A., M.I., J.R.H., O.P.), the University of New South Wales, Sydney; and Sydney Medical School (M.C.K.), Brain and Mind Centre, University of Sydney, Australia.

Abstract

OBJECTIVE:

To contrast the relationships of hormonal eating peptides and hypothalamic volumes to eating behavior and metabolic changes (body mass index [BMI]) in behavioral variant frontotemporal dementia (bvFTD) and semantic variant primary progressive aphasia (svPPA).

METHODS:

Seventy-five patients with dementia (19 bvFTD, 26 svPPA, and 30 Alzheimer disease dementia) and 23 controls underwent fasting blood analyses of leptin, ghrelin, cholecystokinin, peptide tyrosine tyrosine (PYY), and agouti-related peptide (AgRP) levels. On brain MRI anterior, posterior, and total hypothalamic volumes were measured. Relationships between endocrine measures, hypothalamic volumes, eating behaviors, and BMI were investigated.

RESULTS:

Levels of AgRP were higher in patients with bvFTD (69 ± 89 pg/mL) and svPPA (62 ± 81 pg/mL) compared with controls (23 ± 19 pg/mL, p < 0.01). No differences were found for leptin, oxytocin, cholecystokinin, ghrelin, and PYY levels. Patients with bvFTD and svPPA had higher scores on questionnaires measuring eating behaviors. Atrophy of the posterior and total hypothalamus was observed in the bvFTD group only. Linear regression modeling revealed that leptin and AgRP levels predicted BMI.

CONCLUSION:

Eating abnormalities are multifactorial in FTD. In bvFTD, they are in part related to hypothalamic degeneration, with potential disintegration of the network connections between the hypothalamus and orbitofrontal cortex/reward pathways. In svPPA, although hypothalamic volumes are preserved, this group experiences elevated AgRP levels similar to bvFTD, which predicts BMI in both groups. This finding highlights the potential key role of AgRP in eating and metabolic changes and provides a potential target for treatment to modify disease progression.

PMID:
26377252
PMCID:
PMC4617167
DOI:
10.1212/WNL.0000000000002018
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for HighWire Icon for PubMed Central
Loading ...
Support Center