Symptomatological characteristics distinguish between frontotemporal dementia and vascular dementia with a dominant frontal lobe syndrome.
OBJECTIVE
Our hypothesis was that patients with vascular dementia and a dominating frontal lobe syndrome have a symptomatology that reflects a more widespread lesion compared with patients with frontotemporal dementia.


METHODS
Patients with vascular dementia and a dominating frontal lobe syndrome (VAD-F; N = 11) were compared with regard to clinical symptoms and imaging features on CT scans of the brain with patients with frontotemporal dementia (FTD; N = 21).


METHODS
A neuropsychiatric diagnostic ward.


METHODS
Thirty-two inpatients, aged 48-78 years, with frontotemporal dementia or vascular dementia.


METHODS
Relatives were questioned about the initial symptoms. At the clinical investigation, mental and neurological symptoms and signs were recorded using the STEP method (stepwise comparative status analysis). CT scan features of the brain were evaluated by a trained neuroradiologist. The GBS-i (Gottfries-Bråne-Steen, intellectual variables) scale was used to measure the degree of dementia.


RESULTS
At the onset of dementia, loss of memory (p < 0.001), sudden onset (p < 0.001), confusion (p < 0.05) and unspecified neurological signs (p < 0.05) had been significantly more frequent in the VAD-F group. At the time of the clinical investigation, lack of social awareness and presence of primitive reflexes were more frequent in the FTD group (p < 0.01 and p < 0.05, respectively) and visuospatial deficits more frequent in the VAD-F group (p < 0.05). CT of the brain showed that, apart from brain infarcts (present only in the VAD-F group), paraventricular leukoaraiosis was significantly more pronounced in the VAD-F group (p < 0.05). The groups did not differ with respect to age, age at onset or level of dementia.


CONCLUSIONS
The findings support our hypothesis.
Sjögren
M
M
Department of Psychiatry and Neurochemistry, Sahlgrenska University Hospital, Mölndal, Sweden.
Wallin
A
A
Edman
A
A
D017668:Age of Onset; D000368:Aged; D003221:Confusion / Q000150:complications; D003704:Dementia / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D015140:Dementia, Vascular / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000150:complications; D008875:Middle Aged; D012920:Social Behavior Disorders / Q000150:complications; D014057:Tomography, X-Ray Computed