title: Characterizing Sexual Behavior in Frontotemporal Dementia.
abstract: BACKGROUND
  Frontotemporal dementia (FTD) is characterized by a number of prominent behavioral changes. While FTD has been associated with the presence of aberrant or unusual sexual behaviors in a proportion of patients, few studies have formally investigated changes in sexual function in this disease.
  
  
  OBJECTIVE
  We aimed to systematically quantify changes in sexual behavior, including current symptoms and changes from prior diagnoses, in behavioral-variant (bvFTD) and semantic dementia (SD), compared to Alzheimer's disease (AD).
  
  
  METHODS
  Carers of 49 dementia patients (21 bvFTD, 11 SD, 17 AD) were interviewed using the Sexual Behavior and Intimacy Questionnaire (SIQ), a survey designed to assess changes in sexual function across multiple domains including initiating, level of affection, and aberrant or unusual sexual behavior.
  
  
  RESULTS
  BvFTD patients show prominent hyposexual behavior including decreased affection, initiation, and response to advances by partners, and decreased frequency of sexual relations, compared to AD and to SD patients. The greatest changes in sexual behavior compared to pre-diagnoses were found in the bvFTD group with a 90-100% decrease in initiation, response, and frequency of sexual relations. Notably, aberrant or unusual sexual behavior was reported in a minority of bvFTD and SD patients and occurred in patients who also showed hyposexual behavior toward their partner.
  
  
  CONCLUSIONS
  Overall loss of affection, reduced initiation of sexual activity, and responsiveness is an overwhelming feature of bvFTD. In contrast, aberrant or unusual sexual behavior is observed in the minority of bvFTD patients. The underlying pathophysiology of these changes likely reflects structural and functional changes in frontoinsular and limbic regions including the hypothalamus.
authors.affiliation: Neuroscience Research Australia, Sydney, Australia.|Prince of Wales Clinical School, The University of New South Wales, Sydney, Australia.|ARC Centre of Excellence in Cognition and its Disorders, The University of New South Wales, Sydney, Australia.|Sydney Medical School, Brain & Mind Research Institute, University of Sydney, Australia.
authors.forename: Rebekah M
authors.initials: RM
authors.lastname: Ahmed
authors.affiliation: Neuroscience Research Australia, Sydney, Australia.
authors.forename: Cassandra
authors.initials: C
authors.lastname: Kaizik
authors.affiliation: Neuroscience Research Australia, Sydney, Australia.|School of Psychology, The University of New South Wales, Sydney, Australia.|ARC Centre of Excellence in Cognition and its Disorders, The University of New South Wales, Sydney, Australia.
authors.forename: Muireann
authors.initials: M
authors.lastname: Irish
authors.affiliation: Department of Psychiatry, University of Cambridge, Cambridge, UK.
authors.forename: Eneida
authors.initials: E
authors.lastname: Mioshi
authors.affiliation: Neuroscience Research Australia, Sydney, Australia.|School of Psychology, The University of New South Wales, Sydney, Australia.
authors.forename: Nadene
authors.initials: N
authors.lastname: Dermody
authors.affiliation: Sydney Medical School, Brain & Mind Research Institute, University of Sydney, Australia.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Kiernan
authors.affiliation: Neuroscience Research Australia, Sydney, Australia.|School of Medical Sciences, The University of New South Wales, Sydney, Australia.|ARC Centre of Excellence in Cognition and its Disorders, The University of New South Wales, Sydney, Australia.
authors.forename: Olivier
authors.initials: O
authors.lastname: Piguet
authors.affiliation: Neuroscience Research Australia, Sydney, Australia.|School of Medical Sciences, The University of New South Wales, Sydney, Australia.|ARC Centre of Excellence in Cognition and its Disorders, The University of New South Wales, Sydney, Australia.
authors.forename: John R
authors.initials: JR
authors.lastname: Hodges
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000150:complications; D000704:Analysis of Variance; D016022:Case-Control Studies; D004637:Emergency Services, Psychiatric; D005260:Female; D057180:Frontotemporal Dementia / Q000150:complications*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012725:Sexual Behavior / Q000502:physiology*; D020018:Sexual Dysfunctions, Psychological / Q000175:diagnosis / Q000209:etiology*; D013223:Statistics as Topic; D011795:Surveys and Questionnaires
keywords: Alzheimer’s disease; frontotemporal dementia; sexual function