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J Alzheimers Dis. 2016 Oct 4;54(3):957-970.

First Symptoms and Neurocognitive Correlates of Behavioral Variant Frontotemporal Dementia.

Santamaría-García H1,2,3,4, Reyes P1,4, García A2,3,5, Baéz S2,3, Martinez A1,6, Santacruz JM1,4,7, Slachevsky A8,9,10,11,12, Sigman M13, Matallana D1,4,14, Ibañez A2,3,15,16,17.

Author information

1
Pontificia Universidad Javeriana Bogotá, Colombia.
2
Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Translational and Cognitive Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.
3
National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.
4
Intellectus, Memory and cognition center. Hospital San Ignacio Bogotá, Colombia.
5
Universidad Nacional de Cuyo (UNCuyo), Facultad de Educación Elemental y Especial (FEEyE), Mendoza, Argentina.
6
Université Lumière Lyon 2 - Laboratoire Dynamique du langage, Lyon, France.
7
Departament de Psiquiatria i medicina legal. Universitat Autónoma de Barcelona, Cerdanyola del Vallés, España.
8
Gerosciences Center for Brain Health and Metabolism, Avenida Salvador 486, Providencia, Santiago, Chile.
9
Physiopathology Department, ICBM y East Neuroscience Department, Faculty of Medicine, Universidad de Chile, Avenida Salvador 486, Providencia, Santiago, Chile.
10
Cognitive Neurology and Dementia Unit, Neurology Department, Hospital del Salvador, Av. Salvador 364, Providencia, Santiago, Chile.
11
Center for Advanced Research in Education (CIAE), Universidad de Chile, 8330014, Santiago, Chile.
12
Neurology Department, Clínica Alemana, Santiago, Chile.
13
Universidad Torcuato di Tella Laboratorio de Neurociencias, Buenos Aires, Argentina.
14
Instituto de envejecimiento. Pontificia Universidad Javeriana, Colombia.
15
Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile.
16
Universidad Autónoma del Caribe, Barranquilla, Colombia.
17
Centre of Excellence in Cognition and its Disorders, Australian Research Council (ACR), NSW, Australia.

Abstract

BACKGROUND:

Previous works highlight the neurocognitive differences between apathetic and disinhibited clinical presentations of the behavioral variant frontotemporal dementia (bvFTD). However, little is known regarding how the early presentation (i.e., first symptom) is associated to the neurocognitive correlates of the disease's clinical presentation at future stages of disease.

OBJECTIVES:

We analyzed the neurocognitive correlates of patients with bvFTD who debuted with apathy or disinhibition as first symptom of disease.

METHODS:

We evaluated the neuropsychological, clinical, and neuroanatomical (3T structural images) correlates in a group of healthy controls (n = 30) and two groups of bvFTD patients (presented with apathy [AbvFTD, n = 18] or disinhibition [DbvFTD, n = 16]). To differentiate groups according to first symptoms, we used multivariate analyses.

RESULTS:

The first symptom in patients described the evolution of the disease. AbvFTD and DbvFTD patients showed increased brain atrophy and increased levels of disinhibition and apathy, respectively. Whole brain analyzes in AbvFTD revealed atrophy in the frontal, insular, and temporal areas. DbvFTD, in turn, presented atrophy in the prefrontal regions, temporoparietal junction, insula, and temporoparietal region. Increased atrophy in DbvFTD patients (compared to AbvFTD) was observed in frontotemporal regions. Multivariate analyses confirmed that a set of brain areas including right orbitofrontal, right dorsolateral prefrontal, and left caudate were enough to distinguish the patients' subgroups.∥Conclusion: First symptom in bvFTD patients described the neurocognitive impairments after around three years of disease, playing an important role in the early detection, disease tracking, and neuroanatomical specification of bvFTD, as well as in future research on potential disease-modifying treatments.

KEYWORDS:

Apathy; apathy; behavioral variant frontotemporal dementia; first symptom; voxel-based morphometry

PMID:
27567867
DOI:
10.3233/JAD-160501
[Indexed for MEDLINE]

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