Early stage of behavioral variant frontotemporal dementia: clinical and neuroimaging correlates.
The early stages of behavioral variant frontotemporal dementia (bvFTD) are still not completely characterized. In a consecutive series of patients with probable bvFTD diagnosis confirmed by follow-up, we retrospectively evaluated the features at onset. Patients were reclassified according to presenting features and current diagnostic criteria into probable and possible bvFTD. The term "pre-bvFTD" was adopted for patients with cognitive and/or behavioral impairment not fulfilling bvFTD criteria and no deficits in activities of daily living. One hundred ninety-four subjects were included; at first visit, 70% (n = 136) patients were already classified as probable bvFTD. Of the remaining 30% (n = 58), 60% fulfilled criteria for possible bvFTD, while 40% did not, and were classified as pre-FTD. The neuropsychological pattern in possible bvFTD and pre-bvFTD was similar, although possible bvFTD showed more behavioral abnormalities. Pre-bvFTD subjects had frontotemporal gray matter atrophy, although less extensive than possible bvFTD. Conclusively, most bvFTD patients fulfill current diagnostic criteria at first admission, whereas a relatively small group is characterized by mild behavioral and/or cognitive abnormalities in spite of frontotemporal gray matter atrophy. Our preliminary findings will require a validation in prospective studies involving larger samples of patients.
Centre for Ageing Brain and Neurodegenerative Disorders, Neurology Unit, University of Brescia, Brescia, Italy. Electronic address: bborroni@inwind.it.
Barbara
B
Borroni
Centre for Ageing Brain and Neurodegenerative Disorders, Neurology Unit, University of Brescia, Brescia, Italy.
Maura
M
Cosseddu
Centre for Ageing Brain and Neurodegenerative Disorders, Neurology Unit, University of Brescia, Brescia, Italy.
Andrea
A
Pilotto
Centre for Ageing Brain and Neurodegenerative Disorders, Neurology Unit, University of Brescia, Brescia, Italy.
Enrico
E
Premi
III Laboratory of Analyses, Brescia Hospital, Brescia, Italy.
Silvana
S
Archetti
Neuroradiology Unit, University of Brescia, Brescia, Italy.
Roberto
R
Gasparotti
Institute for Advanced Study IUSS Pavia, Pavia, Italy.
Stefano
S
Cappa
Centre for Ageing Brain and Neurodegenerative Disorders, Neurology Unit, University of Brescia, Brescia, Italy.
Alessandro
A
Padovani
D000368:Aged; D001284:Atrophy; D060825:Cognitive Dysfunction / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D057180:Frontotemporal Dementia / Q000145:classification / Q000175:diagnosis* / Q000473:pathology* / Q000523:psychology; D066128:Gray Matter / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis; D008875:Middle Aged; D059906:Neuroimaging; D012189:Retrospective Studies
Behavioral impairment; Behavioral variant frontotemporal dementia (bvFTD); Frontotemporal dementia; MRI; Mild cognitive impairment (MCI); Pre-bvFTD; Prodromal