Neuropsychological aspects of frontotemporal degeneration

Memory profiles in pathology or biomarker confirmed Alzheimer disease and frontotemporal dementia

OBJECTIVE

We examined verbal list memory in participants with pathology-confirmed or biomarker-supported diagnoses to clarify inconsistencies in comparative memory performance. We hypothesized that Alzheimer disease (AD) participants would show more rapid forgetting, whereas behavioral-variant frontotemporal dementia (bvFTD) participants would show a more dysexecutive pattern. We also explored differences in medial temporal volumes, and relative frontal and medial temporal area contributions to memory consolidation.

PARTICIPANTS AND METHODS

Participants had clinical diagnoses of AD and bvFTD who were pathologically confirmed at autopsy or supported with Pittsburgh compound B amyloid imaging. We used cognitive and imaging data collected at baseline visits for a sample of 26 participants with AD (mean age=63.7, education=16.2, Clinical Dementia Rating=0.8), 25 participants with bvFTD (mean age=60.7; education=15.7; CRD=1.1), and 25 healthy controls (mean age=65.6; education=17.5; Clinical Dementia Rating=0.2).

RESULTS AND CONCLUSIONS

AD participants showed more rapid forgetting than bvFTD, and both groups showed more rapid forgetting than controls. In contrast, bvFTD did not conform to a more dysexecutive pattern of performance as patient groups committed similar number of intrusion errors and showed comparably low rates of improvement on cued recall and recognition trials. For patients with neuroimaging, there were no group differences in medial temporal volumes, which was the only significant predictor of consolidation for both dementia groups.

VALUES: a national multicenter study demonstrating gender differences in amyotrophic lateral sclerosis with behavioral impairment

SUMMARY Aim: This study aims to characterize gender-specific behavioral profiles in nondemented amyotrophic lateral sclerosis subjects with behavioral changes (ALSbi). Methods: Caregivers of 106 subjects (53 male) completed an amyotrophic lateral sclerosis standardized clinical interview framed around the Frontal Behavioral Inventory (FBI) structured questionnaire to rate patients on behaviors associated with declines in frontal and temporal self-regulatory capacities. Subjects evaluated evidenced two or more nonoverlapping behavioral symptoms. Inventory items were grouped into disinhibited, apathetic and stereotypic subclasses for between-gender evaluation by independent t-tests and within-gender evaluation by Mann–Whitney U and Spearman rho. Results: Males showed greater disinhibition (p = 0.000), and loss of insight (p = 0.011), jocularity (p = 0.009) and impulsivity (p = 0.005). Females showed significant relationships between personal neglect and indifference (p = 0.000), impulsivity (p = 0.0.013) and jocularity (p = 0.013). Conclusion: Gender differences are evident in ALSbi, characterized by gender-specific loss of social sophistication, and their characterization may allow for better detection of female ALSbi patients, as well as contribute to treatment planning and quality of life for ALSbi patients and their caregivers.

Atrophy in two attention networks is associated with performance on a Flanker task in neurodegenerative disease

This study investigated the neurobiological basis of attentional control dysfunction in neurodegenerative disease by determining the effect of regional brain atrophy on Flanker task performance of neurodegenerative patients. We hypothesized that atrophy in DLPFC and ACC would be significantly associated with decreased attentional control performance on the Flanker task. We used voxel-based morphometry (VBM) to measure the relationship between MRI measures of regional grey matter atrophy and performance on a version of the Flanker task, measured by accuracy and response time. Sixty-five subjects participated, including patients with frontotemporal dementia, Alzheimer's disease, mild cognitive impairment, non-fluent progressive aphasia, corticobasal degeneration, progressive supranuclear palsy, semantic dementia, and healthy controls. Accuracy measures of attentional control and response time measures of attentional control were associated with two different patterns of regional atrophy across subjects. First, there was an association between left hemisphere DLPFC and ACC atrophy and poorer attentional control accuracy. Second, right hemisphere temporal-parietal junction (TPJ) and ventrolateral prefrontal cortex (VLPFC) and DLPFC atrophy were associated with slower response times during attentional control on accurate trials, which may reflect emergent involvement due to deficits in the DLPFC-ACC network.

Cognitive impairment in neuromuscular disorders

Several studies have suggested the presence of central nervous system involvement manifesting as cognitive impairment in diseases traditionally confined to the peripheral nervous system. The aim of this review is to highlight the character of clinical, genetic, neurofunctional, cognitive, and psychiatric deficits in neuromuscular disorders. A high correlation between cognitive features and cerebral protein expression or function is evident in Duchenne muscular dystrophy, myotonic dystrophy (Steinert disease), and mitochondrial encephalomyopathies; direct correlation between tissue-specific protein expression and cognitive deficits is still elusive in certain neuromuscular disorders presenting with or without a cerebral abnormality, such as congenital muscular dystrophies, congenital myopathies, amyotrophic lateral sclerosis, adult polyglucosan body disease, and limb-girdle muscular dystrophies. No clear cognitive deficits have been found in spinal muscular atrophy and facioscapulohumeral dystrophy.

Frontotemporal dementia, motor neuron disease and tauopathy: clinical and neuropathological study in a family

We report a familial disorder occurring in three patients that presented as frontotemporal dementia (FTD). A neuropathological study was performed in a 58-year-old patient, who developed FTD 2 years prior to the onset of motor neuron disease (MND), and died at age 62. Lesions indicative of associated MND were observed: neuronal loss in the anterior horns of the spinal cord, Bunina bodies, axonal spheroids, degeneration of the pyramidal tracts, and of FTD: decreased neuronal density and laminar microvacuolation of layers II and III in the frontal and temporal cortex. Ubiquitin-only-immunoreactive changes were found in the spinal cord and medulla, but were absent from the temporal and frontal cortex. There were also widespread deposits of various neuronal and glial inclusions containing abnormally phosphorylated tau protein, the Western blotting pattern of which was characterized by two major bands of 64 and 69 kDa. There were no abnormalities of the entire coding sequences of microtubule-associated protein tau (MAPT) and copper-zinc superoxide dismutase (SOD(1)) genes. Our results suggest that FTD associated with MND can be caused by a larger spectrum of neuropathological lesions than commonly accepted.