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Boutoleau-Bretonnière C, Kapogiannis D, El Haj M. The guaranteed euros: Probabilistic discounting in behavioural-variant frontotemporal dementia. J Neuropsychol 2024; 18:239-250. [PMID: 38135907 DOI: 10.1111/jnp.12357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/04/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023]
Abstract
Financial decision-making requires trading off between guaranteed and probabilistic outcomes and between immediate and delayed ones. While research has demonstrated that patients with behavioural-variant frontotemporal dementia (bvFTD) prefer immediate rewards at the expense of future ones (i.e. temporal discounting), little is known about how patients choose between smaller, guaranteed and larger, but probabilistic, outcomes (i.e. probabilistic discounting). We thus investigated probabilistic discounting by inviting 18 patients with bvFTD and 20 control participants to choose between fixed smaller monetary amounts and a fixed larger monetary amount with a variated probability of occurrence (e.g. 'Would you rather have 40€ for sure or a 20% chance of winning 100€?'). Results demonstrated lower scores, indicating higher risk tolerance, on the probabilistic discounting task in patients with bvFTD (while impulsively choosing more immediate rewards on the temporal discounting task) compared to control participants. Probabilistic discounting was significantly correlated with a decline in general cognitive performance in patients with bvFTD. When dealing between smaller, guaranteed, and larger, but probabilistic, rewards, patients with bvFTD tend to prefer guaranteed rewards and discount the uncertain ones.
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Affiliation(s)
| | - Dimitrios Kapogiannis
- Laboratory of Clinical Investigation, National Institute on Aging, Baltimore, Maryland, USA
| | - Mohamad El Haj
- Clinical Gerontology Department, CHU Nantes, Nantes, France
- Institut Universitaire de France, Paris, France
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2
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Wyatt LE, Hewan PA, Hogeveen J, Spreng RN, Turner GR. Exploration versus exploitation decisions in the human brain: A systematic review of functional neuroimaging and neuropsychological studies. Neuropsychologia 2024; 192:108740. [PMID: 38036246 DOI: 10.1016/j.neuropsychologia.2023.108740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 10/15/2023] [Accepted: 11/21/2023] [Indexed: 12/02/2023]
Abstract
Thoughts and actions are often driven by a decision to either explore new avenues with unknown outcomes, or to exploit known options with predictable outcomes. Yet, the neural mechanisms underlying this exploration-exploitation trade-off in humans remain poorly understood. This is attributable to variability in the operationalization of exploration and exploitation as psychological constructs, as well as the heterogeneity of experimental protocols and paradigms used to study these choice behaviours. To address this gap, here we present a comprehensive review of the literature to investigate the neural basis of explore-exploit decision-making in humans. We first conducted a systematic review of functional magnetic resonance imaging (fMRI) studies of exploration-versus exploitation-based decision-making in healthy adult humans during foraging, reinforcement learning, and information search. Eleven fMRI studies met inclusion criterion for this review. Adopting a network neuroscience framework, synthesis of the findings across these studies revealed that exploration-based choice was associated with the engagement of attentional, control, and salience networks. In contrast, exploitation-based choice was associated with engagement of default network brain regions. We interpret these results in the context of a network architecture that supports the flexible switching between externally and internally directed cognitive processes, necessary for adaptive, goal-directed behaviour. To further investigate potential neural mechanisms underlying the exploration-exploitation trade-off we next surveyed studies involving neurodevelopmental, neuropsychological, and neuropsychiatric disorders, as well as lifespan development, and neurodegenerative diseases. We observed striking differences in patterns of explore-exploit decision-making across these populations, again suggesting that these two decision-making modes are supported by independent neural circuits. Taken together, our review highlights the need for precision-mapping of the neural circuitry and behavioural correlates associated with exploration and exploitation in humans. Characterizing exploration versus exploitation decision-making biases may offer a novel, trans-diagnostic approach to assessment, surveillance, and intervention for cognitive decline and dysfunction in normal development and clinical populations.
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Affiliation(s)
- Lindsay E Wyatt
- Department of Psychology, York University, Toronto, ON, Canada
| | - Patrick A Hewan
- Department of Psychology, York University, Toronto, ON, Canada
| | - Jeremy Hogeveen
- Department of Psychology, The University of New Mexico, Albuquerque, NM, USA
| | - R Nathan Spreng
- Montréal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montréal, QC, H3A 2B4, Canada; Department of Psychology, McGill University, Montréal, QC, Canada; Department of Psychiatry, McGill University, Montréal, QC, Canada; McConnell Brain Imaging Centre, Montréal Neurological Institute, McGill University, Montréal, QC, Canada.
| | - Gary R Turner
- Department of Psychology, York University, Toronto, ON, Canada.
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3
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Costello H, Roiser JP, Howard R. Antidepressant medications in dementia: evidence and potential mechanisms of treatment-resistance. Psychol Med 2023; 53:654-667. [PMID: 36621964 PMCID: PMC9976038 DOI: 10.1017/s003329172200397x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 10/13/2022] [Accepted: 12/20/2022] [Indexed: 01/10/2023]
Abstract
Depression in dementia is common, disabling and causes significant distress to patients and carers. Despite widespread use of antidepressants for depression in dementia, there is no evidence of therapeutic efficacy, and their use is potentially harmful in this patient group. Depression in dementia has poor outcomes and effective treatments are urgently needed. Understanding why antidepressants are ineffective in depression in dementia could provide insight into their mechanism of action and aid identification of new therapeutic targets. In this review we discuss why depression in dementia may be a distinct entity, current theories of how antidepressants work and how these mechanisms of action may be affected by disease processes in dementia. We also consider why clinicians continue to prescribe antidepressants in dementia, and novel approaches to understand and identify effective treatments for patients living with depression and dementia.
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Affiliation(s)
- Harry Costello
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Jonathan P. Roiser
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Robert Howard
- Division of Psychiatry, University College London, London, UK
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4
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Relationship of the balloon analog risk task to neurocognitive impairment differs by HIV serostatus and history of major depressive disorder. J Neurovirol 2022; 28:248-264. [PMID: 34981438 PMCID: PMC9187559 DOI: 10.1007/s13365-021-01046-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 11/11/2021] [Accepted: 12/16/2021] [Indexed: 12/27/2022]
Abstract
HIV and major depressive disorder (MDD) commonly co-occur and are both linked to greater risk-taking behavior, possibly due to neurocognitive impairment (NCI). The present study examined the concordance of the Balloon Analog Risk Task (BART), a gold standard measure of risk-taking propensity, with NCI and real-world sexual risk behaviors in PWH with comorbid MDD. Participants included 259 adults, stratified by HIV serostatus (HIV + /HIV −) and lifetime MDD (MDD + /MDD −), who completed neuropsychological testing, the BART, and sexual risk behavior questionnaires. Logistic regression, stratified by HIV serostatus, examined joint effects of MDD and BART (linear and quadratic) on NCI. Follow-up linear regressions examined sexual risk behavior and neurocognitive domain T-scores as correlates of the BART. NCI prevalence was lowest in HIV − /MDD − , but BART scores did not differ by HIV/MDD status. In the HIV + group, BART performance predicted NCI such that high and low BART scores related to greater odds of NCI, but only in dual-risk HIV + /MDD + individuals. HIV + /MDD + individuals with both low and high BART scores exhibited poorer learning and recall, whereas processing speed and executive function were only poor in low BART risk-taking HIV + /MDD + . Higher BART scores linearly related to higher sexual risk behaviors only in MDD + individuals, independent of HIV serostatus. Low and high risk-taking on the BART may reflect discrete neurocognitive profiles in HIV + /MDD + individuals, with differential implications for real-world sexual risk behavior. HIV and comorbid MDD may disturb corticostriatal circuits responsible for integrating affective and neurocognitive components of decision-making, thereby contributing to risk-averse and risk-taking phenotypes.
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5
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Bocchetta M, Malpetti M, Todd EG, Rowe JB, Rohrer JD. Looking beneath the surface: the importance of subcortical structures in frontotemporal dementia. Brain Commun 2021; 3:fcab158. [PMID: 34458729 PMCID: PMC8390477 DOI: 10.1093/braincomms/fcab158] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2021] [Indexed: 12/15/2022] Open
Abstract
Whilst initial anatomical studies of frontotemporal dementia focussed on cortical involvement, the relevance of subcortical structures to the pathophysiology of frontotemporal dementia has been increasingly recognized over recent years. Key structures affected include the caudate, putamen, nucleus accumbens, and globus pallidus within the basal ganglia, the hippocampus and amygdala within the medial temporal lobe, the basal forebrain, and the diencephalon structures of the thalamus, hypothalamus and habenula. At the most posterior aspect of the brain, focal involvement of brainstem and cerebellum has recently also been shown in certain subtypes of frontotemporal dementia. Many of the neuroimaging studies on subcortical structures in frontotemporal dementia have been performed in clinically defined sporadic cases. However, investigations of genetically- and pathologically-confirmed forms of frontotemporal dementia are increasingly common and provide molecular specificity to the changes observed. Furthermore, detailed analyses of sub-nuclei and subregions within each subcortical structure are being added to the literature, allowing refinement of the patterns of subcortical involvement. This review focuses on the existing literature on structural imaging and neuropathological studies of subcortical anatomy across the spectrum of frontotemporal dementia, along with investigations of brain–behaviour correlates that examine the cognitive sequelae of specific subcortical involvement: it aims to ‘look beneath the surface’ and summarize the patterns of subcortical involvement have been described in frontotemporal dementia.
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Affiliation(s)
- Martina Bocchetta
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Maura Malpetti
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge, UK
| | - Emily G Todd
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - James B Rowe
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge, UK.,Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
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Manuel AL, Roquet D, Landin-Romero R, Kumfor F, Ahmed RM, Hodges JR, Piguet O. Interactions between decision-making and emotion in behavioral-variant frontotemporal dementia and Alzheimer's disease. Soc Cogn Affect Neurosci 2020; 15:681-694. [PMID: 32613246 PMCID: PMC7393308 DOI: 10.1093/scan/nsaa085] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 05/16/2020] [Accepted: 06/15/2020] [Indexed: 12/12/2022] Open
Abstract
Negative and positive emotions are known to shape decision-making toward more or less impulsive responses, respectively. Decision-making and emotion processing are underpinned by shared brain regions including the ventromedial prefrontal cortex (vmPFC) and the amygdala. How these processes interact at the behavioral and brain levels is still unclear. We used a lesion model to address this question. Study participants included individuals diagnosed with behavioral-variant frontotemporal dementia (bvFTD, n = 18), who typically present deficits in decision-making/emotion processing and atrophy of the vmPFC, individuals with Alzheimer’s disease (AD, n = 12) who present with atrophy in limbic structures and age-matched healthy controls (CTRL, n = 15). Prior to each choice on the delay discounting task participants were cued with a positive, negative or neutral picture and asked to vividly imagine witnessing the event. As hypothesized, our findings showed that bvFTD patients were more impulsive than AD patients and CTRL and did not show any emotion-related modulation of delay discounting rate. In contrast, AD patients showed increased impulsivity when primed by negative emotion. This increased impulsivity was associated with reduced integrity of bilateral amygdala in AD but not in bvFTD. Altogether, our results indicate that decision-making and emotion interact at the level of the amygdala supporting findings from animal studies.
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Affiliation(s)
- Aurélie L Manuel
- School of Psychology, The University of Sydney, Sydney, Australia.,Brain & Mind Centre, The University of Sydney, Sydney, Australia.,ARC Centre of Excellence in Cognition & its Disorders, Sydney, Australia.,Laboratory for Research in Neuroimaging LREN, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Daniel Roquet
- School of Psychology, The University of Sydney, Sydney, Australia.,Brain & Mind Centre, The University of Sydney, Sydney, Australia.,ARC Centre of Excellence in Cognition & its Disorders, Sydney, Australia
| | - Ramon Landin-Romero
- School of Psychology, The University of Sydney, Sydney, Australia.,Brain & Mind Centre, The University of Sydney, Sydney, Australia.,ARC Centre of Excellence in Cognition & its Disorders, Sydney, Australia
| | - Fiona Kumfor
- School of Psychology, The University of Sydney, Sydney, Australia.,Brain & Mind Centre, The University of Sydney, Sydney, Australia.,ARC Centre of Excellence in Cognition & its Disorders, Sydney, Australia
| | - Rebekah M Ahmed
- Brain & Mind Centre, The University of Sydney, Sydney, Australia.,ARC Centre of Excellence in Cognition & its Disorders, Sydney, Australia.,Clinical Medical School, The University of Sydney, Sydney, Australia
| | - John R Hodges
- Brain & Mind Centre, The University of Sydney, Sydney, Australia.,ARC Centre of Excellence in Cognition & its Disorders, Sydney, Australia.,Clinical Medical School, The University of Sydney, Sydney, Australia
| | - Olivier Piguet
- School of Psychology, The University of Sydney, Sydney, Australia.,Brain & Mind Centre, The University of Sydney, Sydney, Australia.,ARC Centre of Excellence in Cognition & its Disorders, Sydney, Australia
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7
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Heim S, McMillan CT, Olm C, Grossman M. So Many Are "Few," but so Few Are Also "Few" - Reduced Semantic Flexibility in bvFTD Patients. Front Psychol 2020; 11:582. [PMID: 32308637 PMCID: PMC7145969 DOI: 10.3389/fpsyg.2020.00582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 03/11/2020] [Indexed: 12/22/2022] Open
Abstract
The processing of quantifier words such as "many" or "few" is a complex operation supported by a plastic fronto-parietal network predominantly in the left hemisphere. The internal reference criterion defining a quantifier (e.g., ≥50% for "many") can be modified in a learning paradigm. Most interestingly, changing the criterion for one quantifier also leads to a change in the criterion for the untrained quantifier, i.e., a semantic restructuring effect, which is supported by Broca's region in the left inferior frontal cortex. Here, we applied this paradigm to patients with the behavioral variant of fronto-temporal dementia (bvFTD) because they suffer from loss of cognitive flexibility, reduced ability to process quantities and their values, impaired reinforcement learning, and language comprehension deficits. The question was whether the patients would be able to perform the task, show direct learning of the new quantifier meanings, and exhibit cognitive flexibility in terms of semantic restructuring. Eleven bvFTD patients took part in two behavioral experiments. In Experiment 1, in a first baseline block, each individual's criterion for "many" and "few" was assessed. In block 2, subjects received feedback about their decisions. Contrary to their initial notion, a proportion of 40% yellow circles was reinforced as "many." In block 3, the effect of this training on their judgments of "many" and "few" was re-assessed. The group of bvFTD patients showed a learning effect for the new criterion trained for the quantifier "many," but failed to generalize this criterion shift to the other quantifier "few." Experiment 2 was similar to Experiment 1, but the patients were trained in Block 2 to judge 60% of circles as "few," with no training for "many." Again, there was an average learning effect for the trained quantifier "few" over the entire group, but no generalization to "many." Since the patients were still able to perform the task and showed learning of "many" to direct feedback, the data suggest that the generalization process, rather than initial learning, is more vulnerable to fronto-temporal degeneration.
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Affiliation(s)
- Stefan Heim
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical Faculty, RWTH Aachen University, Aachen, Germany
- JARA-Translational Brain Medicine, JARA, Aachen, Germany
| | - Corey T. McMillan
- Department of Neurology, Frontotemporal Degeneration Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Christopher Olm
- Department of Neurology, Frontotemporal Degeneration Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Murray Grossman
- Department of Neurology, Frontotemporal Degeneration Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
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8
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Chen Y, Kumfor F, Landin-Romero R, Irish M, Piguet O. The Cerebellum in Frontotemporal Dementia: a Meta-Analysis of Neuroimaging Studies. Neuropsychol Rev 2019; 29:450-464. [PMID: 31428914 DOI: 10.1007/s11065-019-09414-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 08/05/2019] [Indexed: 12/12/2022]
Abstract
Frontotemporal dementia (FTD) is a neurodegenerative brain disorder primarily affecting the frontal and/or temporal lobes. Three main subtypes have been recognized: behavioural-variant FTD (bvFTD), semantic dementia (SD), and progressive nonfluent aphasia (PNFA), each of which has a distinct clinical and cognitive profile. Although the role of the cerebellum in cognition is increasingly accepted, knowledge of cerebellar changes across neuroimaging modalities and their contribution to behavioural and cognitive changes in FTD syndromes is currently scant. We conducted an anatomical/activation likelihood estimation (ALE) meta-analysis in 53 neuroimaging studies (structural MRI: 42; positron emission tomography: 6; functional MRI: 4; single-photon emission computed tomography: 1) to identify the patterns of cerebellar changes and their relations to profiles of behavioural and cognitive deficits in FTD syndromes. Overall, widespread bilateral cerebellar changes were found in FTD and notably the patterns were subtype specific. In bvFTD, ALE peaks were identified in the bilateral Crus, left lobule VI, right lobules VIIb and VIIIb. In SD, focal cerebellar changes were located in the left Crus I and lobule VI. A separate ALE meta-analysis on PNFA studies was not performed due to the limited number of studies available. In addition, the ALE analysis indicated that bilateral Crus I and Crus II were associated with behavioural disruption and cognitive dysfunction. This ALE meta-analysis provides the quantification of the location and extent of cerebellar changes across the main FTD syndromes, which in turn provides evidence of cerebellar contributions to behavioural and cognitive changes in FTD. These results bring new insights into the mechanisms mediating FTD symptomatology.
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Affiliation(s)
- Yu Chen
- The University of Sydney, School of Psychology, Brain & Mind Centre, Sydney, NSW, Australia
- Australian Research Council Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
| | - Fiona Kumfor
- The University of Sydney, School of Psychology, Brain & Mind Centre, Sydney, NSW, Australia
- Australian Research Council Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
| | - Ramon Landin-Romero
- The University of Sydney, School of Psychology, Brain & Mind Centre, Sydney, NSW, Australia
- Australian Research Council Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
| | - Muireann Irish
- The University of Sydney, School of Psychology, Brain & Mind Centre, Sydney, NSW, Australia
- Australian Research Council Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
| | - Olivier Piguet
- The University of Sydney, School of Psychology, Brain & Mind Centre, Sydney, NSW, Australia.
- Australian Research Council Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia.
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Johnen A, Bertoux M. Psychological and Cognitive Markers of Behavioral Variant Frontotemporal Dementia-A Clinical Neuropsychologist's View on Diagnostic Criteria and Beyond. Front Neurol 2019; 10:594. [PMID: 31231305 PMCID: PMC6568027 DOI: 10.3389/fneur.2019.00594] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 05/20/2019] [Indexed: 12/11/2022] Open
Abstract
Behavioral variant frontotemporal dementia (bvFTD) is the second leading cognitive disorder caused by neurodegeneration in patients under 65 years of age. Characterized by frontal, insular, and/or temporal brain atrophy, patients present with heterogeneous constellations of behavioral and psychological symptoms among which progressive changes in social conduct, lack of empathy, apathy, disinhibited behaviors, and cognitive impairments are frequently observed. Since the histopathology of the disease is heterogeneous and identified genetic mutations only account for ~30% of cases, there are no reliable biomarkers for the diagnosis of bvFTD available in clinical routine as yet. Early detection of bvFTD thus relies on correct application of clinical diagnostic criteria. Their evaluation however, requires expertise and in-depth assessments of cognitive functions, history taking, clinical observations as well as caregiver reports on behavioral and psychological symptoms and their respective changes. With this review, we aim for a critical appraisal of common methods to access the behavioral and psychological symptoms as well as the cognitive alterations presented in the diagnostic criteria for bvFTD. We highlight both, practical difficulties as well as current controversies regarding an overlap of symptoms and particularly cognitive impairments with other neurodegenerative and primary psychiatric diseases. We then review more recent developments and evidence on cognitive, behavioral and psychological symptoms of bvFTD beyond the diagnostic criteria which may prospectively enhance the early detection and differential diagnosis in clinical routine. In particular, evidence on specific impairments in social and emotional processing, praxis abilities as well as interoceptive processing in bvFTD is summarized and potential links with behavior and classic cognitive domains are discussed. We finally outline both, future opportunities and major challenges with regard to the role of clinical neuropsychology in detecting bvFTD and related neurocognitive disorders.
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Affiliation(s)
- Andreas Johnen
- Section for Neuropsychology, Department of Neurology, University Hospital Münster, Münster, Germany
| | - Maxime Bertoux
- Univ Lille, Inserm UMR 1171 Degenerative and Vascular Cognitive Disorders, CHU Lille, Lille, France
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10
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Kitamura S, Shimada H, Niwa F, Endo H, Shinotoh H, Takahata K, Kubota M, Takado Y, Hirano S, Kimura Y, Zhang MR, Kuwabara S, Suhara T, Higuchi M. Tau-induced focal neurotoxicity and network disruption related to apathy in Alzheimer's disease. J Neurol Neurosurg Psychiatry 2018; 89:1208-1214. [PMID: 29884723 PMCID: PMC6227800 DOI: 10.1136/jnnp-2018-317970] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Revised: 04/16/2018] [Accepted: 05/15/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Apathy is a common neuropsychological symptom in Alzheimer's disease (AD), and previous studies demonstrated that neuronal loss and network disruption in some brain regions play pivotal roles in the pathogenesis of apathy. However, contributions of tau and amyloid-β (Aβ) depositions, pathological hallmarks of AD, to the manifestation of apathy remain elusive. METHODS Seventeen patients with AD underwent positron emission tomography (PET) with 11C-pyridinyl-butadienyl-benzothiazole 3 (11C-PBB3) and 11C-Pittsburgh compound-B (11C-PiB) to estimate tau and Aβ accumulations using standardised uptake value ratio (SUVR) images. 11C-PBB3 and 11C-PiB SUVR were compared between AD patients with high and low Apathy Scale (AS) scores. Additionally, volumetric and diffusion tensor MRI was performed in those areas where any significant difference was observed in PET analyses. Correlation and path analyses among AS and estimated imaging parameters were also conducted. RESULTS AD patients with high AS scores showed higher 11C-PBB3 SUVR in the orbitofrontal cortex (OFC) than those with low AS scores, while 11C-PiB SUVR in any brain regions did not differ between them. Elevated 11C-PBB3 SUVR in OFC, decreased OFC thickness and decreased fractional anisotropy (FA) in the uncinate fasciculus (UNC), which is structurally connected to OFC, correlated significantly with increased scores of the AS. Path analysis indicated that increased 11C-PBB3 SUVR in OFC affects apathy directly and through reduction of OFC thickness and subsequent decrease of FA in UNC. CONCLUSIONS The present findings suggested that tau pathology in OFC may provoke focal neurotoxicity in OFC and the following disruption of the OFC-UNC network, leading to the emergence and progression of apathy in AD.
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Affiliation(s)
- Soichiro Kitamura
- Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
- Department of Psychiatry, Nara Medical University, Kashihara, Japan
| | - Hitoshi Shimada
- Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Fumitoshi Niwa
- Department of Neurology and Gerontology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hironobu Endo
- Division of Neurology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hitoshi Shinotoh
- Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
- Neurology Chiba Clinic, Chiba, Japan
| | - Keisuke Takahata
- Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Manabu Kubota
- Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Yuhei Takado
- Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Shigeki Hirano
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yasuyuki Kimura
- Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
- Department of Clinical and Experimental Neuroimaging, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Ming-Rong Zhang
- Department of Radiopharmaceutics Development, National Institute of Radiological Sciences (NIRS), National Institutes for Quantum and Radiological Science and Technology (QST), Chiba, Japan
| | - Satoshi Kuwabara
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Tetsuya Suhara
- Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Makoto Higuchi
- Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
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11
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Roberts S, Henry JD, Molenberghs P. Immoral behaviour following brain damage: A review. J Neuropsychol 2018; 13:564-588. [DOI: 10.1111/jnp.12155] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 02/21/2018] [Indexed: 12/30/2022]
Affiliation(s)
- Stefanie Roberts
- School of Psychological Sciences Monash Institute of Cognitive and Clinical Neurosciences Monash University Clayton Victoria Australia
| | - Julie D. Henry
- School of Psychology University of Queensland St Lucia Queensland Australia
| | - Pascal Molenberghs
- School of Psychological Sciences The University of Melbourne Parkville Victoria Australia
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12
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Wong S, Irish M, Savage G, Hodges JR, Piguet O, Hornberger M. Strategic value-directed learning and memory in Alzheimer's disease and behavioural-variant frontotemporal dementia. J Neuropsychol 2018; 13:328-353. [PMID: 29431279 DOI: 10.1111/jnp.12152] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 01/17/2018] [Indexed: 12/22/2022]
Abstract
In healthy adults, the ability to prioritize learning of highly valued information is supported by executive functions and enhances subsequent memory retrieval for this information. In Alzheimer's disease (AD) and behavioural-variant frontotemporal dementia (bvFTD), marked deficits are evident in learning and memory, presenting in the context of executive dysfunction. It is unclear whether these patients show a typical memory bias for higher valued stimuli. We administered a value-directed word-list learning task to AD (n = 10) and bvFTD (n = 21) patients and age-matched healthy controls (n = 22). Each word was assigned a low, medium or high point value, and participants were instructed to maximize the number of points earned across three learning trials. Participants' memory for the words was assessed on a delayed recall trial, followed by a recognition test for the words and corresponding point values. Relative to controls, both patient groups showed poorer overall learning, delayed recall and recognition. Despite these impairments, patients with AD preferentially recalled high-value words on learning trials and showed significant value-directed enhancement of recognition memory for the words and points. Conversely, bvFTD patients did not prioritize recall of high-value words during learning trials, and this reduced selectivity was related to inhibitory dysfunction. Nonetheless, bvFTD patients showed value-directed enhancement of recognition memory for the point values, suggesting a mismatch between memory of high-value information and the ability to apply this in a motivationally salient context. Our findings demonstrate that value-directed enhancement of memory may persist to some degree in patients with dementia, despite pronounced deficits in learning and memory.
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Affiliation(s)
- Stephanie Wong
- ARC Centre of Excellence in Cognition and Its Disorders, Sydney, New South Wales, Australia.,Department of Psychology, Macquarie University, Sydney, New South Wales, Australia.,Neuroscience Research Australia, Sydney, New South Wales, Australia.,School of Psychology, The University of Sydney, New South Wales, Australia
| | - Muireann Irish
- ARC Centre of Excellence in Cognition and Its Disorders, Sydney, New South Wales, Australia.,Neuroscience Research Australia, Sydney, New South Wales, Australia.,School of Psychology, The University of Sydney, New South Wales, Australia.,Brain & Mind Centre, The University of Sydney, New South Wales, Australia
| | - Greg Savage
- ARC Centre of Excellence in Cognition and Its Disorders, Sydney, New South Wales, Australia.,Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - John R Hodges
- ARC Centre of Excellence in Cognition and Its Disorders, Sydney, New South Wales, Australia.,Neuroscience Research Australia, Sydney, New South Wales, Australia.,Brain & Mind Centre, The University of Sydney, New South Wales, Australia.,School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia.,Central Clinical School, Sydney Medical School, The University of Sydney, New South Wales, Australia
| | - Olivier Piguet
- ARC Centre of Excellence in Cognition and Its Disorders, Sydney, New South Wales, Australia.,Neuroscience Research Australia, Sydney, New South Wales, Australia.,School of Psychology, The University of Sydney, New South Wales, Australia.,Brain & Mind Centre, The University of Sydney, New South Wales, Australia
| | - Michael Hornberger
- ARC Centre of Excellence in Cognition and Its Disorders, Sydney, New South Wales, Australia.,Norwich Medical School, University of East Anglia, Norwich, UK.,Dementia and Complexity in Later Life, NHS Norfolk and Suffolk Foundation Trust, UK
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13
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Ward AM, Calamia M, Thiemann E, Dunlap J, Tranel D. Association between olfaction and higher cortical functions in Alzheimer's disease, mild cognitive impairment, and healthy older adults. J Clin Exp Neuropsychol 2016; 39:646-658. [PMID: 27868477 DOI: 10.1080/13803395.2016.1253667] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Neural regions important for smell are proximal and closely connected to cortical areas that have been strongly implicated in higher order functions of value-based decision making and emotional memory. The integrity of these neural regions are affected in aging and neurodegenerative conditions. Two specific predictions follow from these neuroanatomical arrangements-namely, that olfaction would be associated with value-based decision making and with emotional memory. METHOD To test these predictions, we measured these different capacities in participants with presumed varying degrees of integrity of the relevant brain structures: specifically, 13 patients with Alzheimer's disease, 8 patients with mild cognitive impairment, and 20 healthy older adults. The participants completed detailed tests of olfaction, value-based decision making, emotional memory, and general cognitive ability. RESULTS Olfactory functioning was significantly associated with emotional and nonemotional memory. The association was especially strong and consistent for memory recall with olfaction, explaining as much as 10% additional variance over and above general cognition. Olfactory functioning was not strongly or consistently associated with decision making over and above general cognition. CONCLUSION Olfaction is a strong predictor of memory recall. These findings may contribute to a better understanding of olfaction and specific cognitive domains known to be affected by aging and implicated in neurodegenerative disease.
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Affiliation(s)
- Amanda M Ward
- a Department of Psychological and Brain Sciences , University of Iowa , Iowa City , IA , USA
| | - Matthew Calamia
- b Department of Psychology , Louisiana State University , Baton Rouge , LA , USA
| | - Erin Thiemann
- a Department of Psychological and Brain Sciences , University of Iowa , Iowa City , IA , USA
| | - Jamie Dunlap
- a Department of Psychological and Brain Sciences , University of Iowa , Iowa City , IA , USA
| | - Daniel Tranel
- a Department of Psychological and Brain Sciences , University of Iowa , Iowa City , IA , USA.,c Department of Neurology , University of Iowa Carver College of Medicine , Iowa City , IA , USA
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14
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Yu J, Mamerow L, Lei X, Fang L, Mata R. Altered Value Coding in the Ventromedial Prefrontal Cortex in Healthy Older Adults. Front Aging Neurosci 2016; 8:210. [PMID: 27630561 PMCID: PMC5005953 DOI: 10.3389/fnagi.2016.00210] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 08/19/2016] [Indexed: 12/01/2022] Open
Abstract
Previous work suggests that aging is associated with changes in risk taking but less is known about their underlying neural basis, such as the potential age differences in the neural processing of value and risk. The goal of the present study was to investigate adult age differences in functional neural responses in a naturalistic risk-taking task. Twenty-six young adults and 27 healthy older adults completed the Balloon Analogue Risk Task while undergoing functional magnetic resonance imaging. Young and older adults showed similar overt risk-taking behavior. Group comparison of neural activity in response to risky vs. control stimuli revealed similar patterns of activation in the bilateral striatum, anterior insula (AI) and ventromedial prefrontal cortex (vmPFC). Group comparison of parametrically modulated activity in response to continued pumping similarly revealed comparable results for both age groups in the AI and, potentially, the striatum, yet differences emerged for regional activity in the vmPFC. At whole brain level, insular, striatal and vmPFC activation was predictive of behavioral risk taking for young but not older adults. The current results are interpreted and discussed as preserved neural tracking of risk and reward in the AI and striatum, respectively, but altered value coding in the vmPFC in the two age groups. The latter finding points toward older adults exhibiting differential vmPFC-related integration and value coding. Furthermore, neural activation holds differential predictive validity for behavioral risk taking in young and older adults.
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Affiliation(s)
- Jing Yu
- Faculty of Psychology, Southwest UniversityChongqing, China; Department for Cognitive and Decision Sciences, University of BaselBasel, Switzerland; Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of SciencesBeijing, China
| | - Loreen Mamerow
- Department for Cognitive and Decision Sciences, University of Basel Basel, Switzerland
| | - Xu Lei
- Faculty of Psychology, Southwest University Chongqing, China
| | - Lei Fang
- Faculty of Medicine, Southeast University Nanjing, China
| | - Rui Mata
- Department for Cognitive and Decision Sciences, University of BaselBasel, Switzerland; Max Planck Institute for Human DevelopmentBerlin, Germany
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15
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Teng C, Otero M, Geraci M, Blair R, Pine DS, Grillon C, Blair KS. Abnormal decision-making in generalized anxiety disorder: Aversion of risk or stimulus-reinforcement impairment? Psychiatry Res 2016; 237:351-6. [PMID: 26822065 PMCID: PMC4988522 DOI: 10.1016/j.psychres.2015.12.031] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 11/03/2015] [Accepted: 12/25/2015] [Indexed: 12/22/2022]
Abstract
There is preliminary data indicating that patients with generalized anxiety disorder (GAD) show impairment on decision-making tasks requiring the appropriate representation of reinforcement value. The current study aimed to extend this literature using the passive avoidance (PA) learning task, where the participant has to learn to respond to stimuli that engender reward and avoid responding to stimuli that engender punishment. Six stimuli engendering reward and six engendering punishment are presented once per block for 10 blocks of trials. Thirty-nine medication-free patients with GAD and 29 age-, IQ and gender matched healthy comparison individuals performed the task. In addition, indexes of social functioning as assessed by the Global Assessment of Functioning (GAF) scale were obtained to allow for correlational analyzes of potential relations between cognitive and social impairments. The results revealed a Group-by-Error Type-by-Block interaction; patients with GAD committed significantly more commission (passive avoidance) errors than comparison individuals in the later blocks (blocks 7,8, and 9). In addition, the extent of impairment on these blocks was associated with their functional impairment as measured by the GAF scale. These results link GAD with anomalous decision-making and indicate that a potential problem in reinforcement representation may contribute to the severity of expression of their disorder.
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Affiliation(s)
| | | | | | | | | | | | - Karina S. Blair
- Correspondence to: National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, 15K North Drive, Rm 115A, MSC 2670, Bethesda, MA 20892-2670, USA
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16
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Nasiriavanaki Z, ArianNik M, Abbassian A, Mahmoudi E, Roufigari N, Shahzadi S, Nasiriavanaki M, Bahrami B. Prediction of individual differences in risky behavior in young adults via variations in local brain structure. Front Neurosci 2015; 9:359. [PMID: 26500482 PMCID: PMC4595786 DOI: 10.3389/fnins.2015.00359] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 09/18/2015] [Indexed: 11/13/2022] Open
Abstract
In recent years the problem of how inter-individual differences play a role in risk-taking behavior has become a much debated issue. We investigated this problem based on the well-known balloon analog risk task (BART) in 48 healthy subjects in which participants inflate a virtual balloon opting for a higher score in the face of a riskier chance of the balloon explosion. In this study, based on a structural Voxel Based Morphometry (VBM) technique we demonstrate a significant positive correlation between BART score and size of the gray matter volume in the anterior insula in riskier subjects. Although the anterior insula is among the candidate brain areas that were involved in the risk taking behavior in fMRI studies, here based on our structural data it is the only area that was significantly related to structural variation among different subjects.
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Affiliation(s)
- Zahra Nasiriavanaki
- Medical Faculty, Shahid Beheshti University of Medical Sciences Tehran, Iran
| | - Mohsen ArianNik
- Medical Faculty, Shahid Beheshti University of Medical Sciences Tehran, Iran
| | - Abdolhosein Abbassian
- School of Mathematics, Institute for Research in Fundamental Sciences Tehran, Iran ; School of Cognitive Sciences, Institute for Research in Fundamental Sciences Tehran, Iran
| | - Elham Mahmoudi
- Medical Faculty, Tehran University of Medical Sciences Tehran, Iran
| | - Neda Roufigari
- Medical Faculty, Tehran University of Medical Sciences Tehran, Iran
| | - Sohrab Shahzadi
- School of Cognitive Sciences, Institute for Research in Fundamental Sciences Tehran, Iran
| | - Mohammadreza Nasiriavanaki
- Department of Biomedical Engineering, College of Engineering and School of Medicine Wayne State University Detroit, MI, USA
| | - Bahador Bahrami
- Department of Cognitive Neuroscience, University College London London, UK
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17
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Campbell JA, Samartgis JR, Crowe SF. Impaired decision making on the Balloon Analogue Risk Task as a result of long-term alcohol use. J Clin Exp Neuropsychol 2013; 35:1071-81. [DOI: 10.1080/13803395.2013.856382] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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18
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Whitwell JL, Josephs KA. Recent advances in the imaging of frontotemporal dementia. Curr Neurol Neurosci Rep 2013; 12:715-23. [PMID: 23015371 DOI: 10.1007/s11910-012-0317-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Neuroimaging has played an important role in the characterization of the frontotemporal dementia (FTD) syndromes, demonstrating neurodegenerative signatures that can aid in the differentiation of FTD from other neurodegenerative disorders. Recent advances have been driven largely by the refinement of the clinical syndromes that underlie FTD, and by the discovery of new genetic and pathological features associated with FTD. Many new imaging techniques and modalities are also now available that allow the assessment of other aspects of brain structure and function, such as diffusion tensor imaging and resting-state functional MRI. Studies have used these recent techniques, as well as traditional volumetric MRI, to provide further insight into disease progression across the many clinical, genetic, and pathological variants of FTD. Importantly, neuroimaging signatures have been identified that will improve the clinician's ability to predict underlying genetic and pathological features, and hence ultimately improve patient diagnosis.
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Affiliation(s)
- Jennifer L Whitwell
- Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA.
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Harciarek M, Cosentino S. Language, executive function and social cognition in the diagnosis of frontotemporal dementia syndromes. Int Rev Psychiatry 2013; 25:178-96. [PMID: 23611348 PMCID: PMC4481322 DOI: 10.3109/09540261.2013.763340] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Frontotemporal dementia (FTD) represents a spectrum of non-Alzheimer's degenerative conditions associated with focal atrophy of the frontal and/or temporal lobes. Frontal and temporal regions of the brain have been shown to be strongly involved in executive function, social cognition and language processing and, thus, deficits in these domains are frequently seen in patients with FTD or may even be hallmarks of a specific FTD subtype (i.e. relatively selective and progressive language impairment in primary progressive aphasia). In this review we have attempted to delineate how language, executive function, and social cognition may contribute to the diagnosis of FTD syndromes, namely the behavioural variant FTD as well as the language variants of FTD including the three subtypes of primary progressive aphasia (PPA): non-fluent/agrammatic, semantic and logopenic. This review also addresses the extent to which deficits in these cognitive areas contribute to the differential diagnosis of FTD versus Alzheimer's disease (AD). Finally, early clinical determinants of pathology are briefly discussed and contemporary challenges to the diagnosis of FTD are presented.
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Affiliation(s)
- Michał Harciarek
- Division of Clinical Psychology and Neuropsychology, Institute of Psychology, University of Gdańsk, Poland.
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