title: Beyond cognitive reserve: behavioural reserve hypothesis in Frontotemporal Dementia.
abstract: BACKGROUND
  The brain reserve hypothesis posits that there are individual differences in the ability to cope with brain pathology, and that brain damage extent and clinical symptoms are not tightly linked. If cognitive reserve hypothesis has been demonstrated in Alzheimer Disease and Frontotemporal Dementia (FTD), no evidence of reserve mechanisms on behavioural disturbances has been corroborated yet. In FTD, distinct behavioural phenotypes may be identified.
  
  
  OBJECTIVE
  To test the behavioural reserve hypothesis in behavioural variant FTD (bvFTD).
  
  
  METHODS
  As previously demonstrated, bvFTD patients were grouped into four behavioural phenotypes, i.e. "disinhibited", "apathetic", "language", and "aggressive", by means of Confirmatory Factor Analysis on behavioural assessment. Educational achievement was considered as proxy measure of reserve on behavioural disturbances, and cerebral SPECT as an indirect expression of brain pathology. On each group, the effect of education on brain damage was assessed by slope analysis.
  
  
  RESULTS
  A specific effect of education attainment on "disinhibited" phenotype was observed, the higher the education, the greater the hypoperfusion in the right inferior frontal gyrus and the left medial frontal gyrus and right caudate (P<0.001). On the other behavioural phenotypes, no effect of education was reported in modulating brain damage.
  
  
  CONCLUSIONS
  We suggest that in neurodegenerative diseases the concept of brain reserve might be extended, as compensatory mechanisms are in action not only for cognitive deficits but for behavioural disturbances as well.
authors: Centre for Ageing Brain and Neurodegenerative Disorders, Neurology Unit, University of Brescia, Italy.
authors: Enrico
authors: E
authors: Premi
authors: Valentina
authors: V
authors: Garibotto
authors: Stefano
authors: S
authors: Gazzina
authors: Mario
authors: M
authors: Grassi
authors: Maura
authors: M
authors: Cosseddu
authors: Barbara
authors: B
authors: Paghera
authors: Marinella
authors: M
authors: Turla
authors: Alessandro
authors: A
authors: Padovani
authors: Barbara
authors: B
authors: Borroni
mesh_terms: D000368:Aged; D001519:Behavior / Q000502:physiology*; D001921:Brain / Q000000981:diagnostic imaging; D001931:Brain Mapping; D002421:Caudate Nucleus / Q000098:blood supply / Q000000981:diagnostic imaging; D058245:Cognitive Reserve / Q000502:physiology*; D003545:Cysteine / Q000031:analogs & derivatives; D004522:Educational Status; D005163:Factor Analysis, Statistical; D005260:Female; D005625:Frontal Lobe / Q000098:blood supply / Q000000981:diagnostic imaging; D057180:Frontotemporal Dementia / Q000000981:diagnostic imaging / Q000523:psychology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D012044:Regression Analysis; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C059659:technetium Tc 99m bicisate; D003545:Cysteine