Orbitofrontal dysfunction related to both apathy and disinhibition in frontotemporal dementia.
Orbitofrontal metabolic impairment is characteristic of the frontal variant of frontotemporal dementia (fv-FTD), as are early changes in emotional and social conduct. Two main types of behavioral disturbances have been distinguished in fv-FTD patients: apathetic and disinhibited manifestations. In this study, we searched for relationships between brain metabolism and presence of apathetic or disinhibited behavior. Metabolic activity and behavioral data were collected in 41 fv-FTD patients from European PET centers. A conjunction analysis of the PET data showed an expected impairment of metabolic activity in the anterior cingulate, ventromedial and orbital prefrontal cortex, the dorsolateral prefrontal cortex and the left anterior insula in fv-FTD subjects compared to matched controls. A correlation was observed between disinhibition scores on the Neuropsychiatric Inventory scale and a cluster of voxels located in the posterior orbitofrontal cortex (6, 28, -24). Comparison of brain activity between apathetic and nonapathetic fv-FTD patients from two centers also revealed a specific involvement of the posterior orbitofrontal cortex in apathetic subjects (4, 22, -22). The results confirm that the main cerebral metabolic impairment in fv-FTD patients affects areas specializing in emotional evaluation and demonstrate that decreased orbitofrontal activity is related to both disinhibited and apathetic syndromes in fv-FTD.
Cyclotron Research Center, University of Liège, Liège, Belgium. Frederic.Peters@ulg.ac.be
Frédéric
F
Peters
Daniela
D
Perani
Karl
K
Herholz
Vjera
V
Holthoff
Bettina
B
Beuthien-Baumann
Sandro
S
Sorbi
Alberto
A
Pupi
Christian
C
Degueldre
Christian
C
Lemaire
Fabienne
F
Collette
Eric
E
Salmon
D000368:Aged; D003072:Cognition Disorders / Q000175:diagnosis; D003704:Dementia / Q000473:pathology / Q000503:physiopathology / Q000523:psychology; D003863:Depression / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D019788:Fluorodeoxyglucose F18; D005625:Frontal Lobe / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D007266:Inhibition, Psychological; D008297:Male; D009483:Neuropsychological Tests; D049268:Positron-Emission Tomography; D017397:Prefrontal Cortex / Q000503:physiopathology*; D019275:Radiopharmaceuticals; D012720:Severity of Illness Index; D013702:Temporal Lobe / Q000378:metabolism / Q000473:pathology*
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18