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Alzheimers Dement (Amst). 2018 Nov 3;10:750-754. doi: 10.1016/j.dadm.2018.10.001. eCollection 2018.

A very light lunch: Interoceptive deficits and food aversion at onset in a case of behavioral variant frontotemporal dementia.

Author information

1
Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
2
Cognitive Neuropsychology Centre, ASST "Grande Ospedale Metropolitano" Niguarda, Milan, Italy.
3
NeuroMi, Milan Centre for Neuroscience, Milano, Italy.
4
Neurodegenerative Disease Unit, Department of Pathophysiology and Transplantation, Centro Dino Ferrari, University of Milan, Fondazione Ca' Granda IRCCS Ospedale Maggiore Policlinico, Milan, Italy.
5
Department of Neuroradiology, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy.
6
Department of Psychology, University of Milano-Bicocca, Milano, Italy.
7
IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.

Abstract

Introduction:

Patients affected by the behavioral variant frontotemporal dementia (bvFTD) frequently experience, at a delayed onset, abnormal eating behavior involving increased food intake. Although delusional food-related symptoms have attracted much attention, the behavioral and neural features of food aversion manifestations in bvFTD remain poorly documented.

Methods:

We describe the rare case of a patient with bvFTD presenting with lack of interoception for swallowing and digestion, coupled with a dramatic food aversion at onset. We also compared his MRI scan to 84 healthy individuals using a voxel-based morphometry approach.

Results:

We found gray matter density reductions involving the postcentral gyrus bilaterally, insulae, and right medial orbitofrontal cortex.

Discussion:

Our results shed new light on the behavioral and neuroanatomical features of food aversion and interoception deficits in bvFTD, suggesting that besides orbitofrontal cortex, also a distributed system associated with interoception might play a role in such behavioral manifestation.

KEYWORDS:

Behavioral variant frontotemporal dementia; Eating disturbances; Insula; Interoception; Voxel-based morphometry

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