title: Executive dysfunction in frontotemporal dementia and corticobasal syndrome.
abstract: OBJECTIVE
  To determine the pattern of executive dysfunction in frontotemporal dementia (FTD) and corticobasal syndrome (CBS) and to determine the brain areas associated with executive dysfunction in these illnesses.
  
  
  METHODS
  We administered the Delis-Kaplan Executive Function System (D-KEFS), a collection of standardized executive function tests, to 51 patients with behavioral-variant FTD and 50 patients with CBS. We also performed a discriminant analysis on the D-KEFS to determine which executive function tests best distinguished the clinical diagnoses of FTD and CBS. Finally, we used voxel-based morphometry (VBM) to determine regional gray matter volume loss associated with executive dysfunction.
  
  
  RESULTS
  Patients with FTD and patients with CBS showed executive dysfunction greater than memory dysfunction. Executive function was better preserved in the patients with CBS than the patients with FTD with the exception of tests that required motor, visuospatial ability, or both. In patients with CBS, dorsal frontal and parietal and temporal-parietal cortex was associated with executive function. In FTD, tests with a language component (Verbal Fluency) were associated with left perisylvian cortex, sorting with the left dorsolateral prefrontal cortex, and reasoning (the Twenty Questions task) with the left anterior frontal cortex. The Twenty Questions test best distinguished the clinical diagnoses of CBS and FTD.
  
  
  CONCLUSIONS
  The neuroanatomic findings (especially in frontotemporal dementia [FTD]) agree with the previous literature on this topic. Patients with FTD and patients with corticobasal syndrome (CBS) show disparate performance on higher-order executive functions, especially the Twenty Questions test. It may be difficult to distinguish motor and visuospatial ability from executive function in patients with CBS using tests with significant motor and visuospatial demands such as Trail Making.
authors.affiliation: Cognitive Neuroscience Section, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD 20892-1440, USA.
authors.forename: E D
authors.initials: ED
authors.lastname: Huey
authors.forename: E N
authors.initials: EN
authors.lastname: Goveia
authors.forename: S
authors.initials: S
authors.lastname: Paviol
authors.forename: M
authors.initials: M
authors.lastname: Pardini
authors.forename: F
authors.initials: F
authors.lastname: Krueger
authors.forename: G
authors.initials: G
authors.lastname: Zamboni
authors.forename: M C
authors.initials: MC
authors.lastname: Tierney
authors.forename: E M
authors.initials: EM
authors.lastname: Wassermann
authors.forename: J
authors.initials: J
authors.lastname: Grafman
mesh_terms: D000368:Aged; D001931:Brain Mapping; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D003657:Decision Making / Q000502:physiology; D003704:Dementia / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D018450:Disease Progression; D005260:Female; D005625:Frontal Lobe / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007807:Language Tests; D008279:Magnetic Resonance Imaging; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D008875:Middle Aged; D009483:Neuropsychological Tests; D010296:Parietal Lobe / Q000473:pathology / Q000503:physiopathology; D011237:Predictive Value of Tests; D011597:Psychomotor Performance / Q000502:physiology; D013577:Syndrome; D013702:Temporal Lobe / Q000473:pathology / Q000503:physiopathology; D014705:Verbal Behavior / Q000502:physiology; D014836:Volition / Q000502:physiology